Individual provider Active NPI

Leemarie Monzon Lewis, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Anaheim, CA
National Provider Identifier
1720872195
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95033239 Issued in CA
Practice address
511 S Kroeger St
Anaheim, CA 92805-4728
Phone
(951) 719-9440
NPI assigned
Apr 8, 2025
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95033239 CA Primary

Addresses

Primary practice location

511 S Kroeger St
Anaheim, CA 92805-4728

Mailing address

511 S Kroeger St
Anaheim, CA 92805-4728
Phone (951) 719-9440

Other names 1

  • Leemarie Ragadio Monzon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250815003828 CA Practitioner - Nurse Practitioner 5991204026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

511 S Kroeger St
Anaheim, CA 92805-4728

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95033239CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Medical, PC Psychiatric/Mental Health CurrentSince Aug 1, 2025 Accepting new patients

Locations

1720 W Ball Rd
Ste 4C
Anaheim, CA 92804
Phone (714) 683-1472

5871 Pine Ave
Ste 120
Chino Hills, CA 91709
Phone (714) 683-1472

1800 Wilshire Blvd
Los Angeles, CA 90057
Phone (213) 478-0460

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1744070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1720872195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 S KROEGER ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928054728",
            "telephone_number": "951-719-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 S KROEGER ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928054728",
            "telephone_number": "951-719-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "LEEMARIE",
        "middle_name": "MONZON",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95033239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEEMARIE",
            "last_name": "MONZON",
            "middle_name": "RAGADIO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.