Individual provider Active NPI

Alyssa Grisham

  • Critical Care Medicine Nurse Practitioner
  • Redlands, CA
National Provider Identifier
1720946684
Registry record updated Aug 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
95040134 Issued in CA
Practice address
425 Wilbar Cir
Redlands, CA 92374-6352
Phone
(909) 352-2366
NPI assigned
Jan 12, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X 95040134 CA Primary
Nurse Practitioner 363L00000X 95040134 CA

Addresses

Primary practice location

425 Wilbar Cir
Redlands, CA 92374-6352

Mailing address

425 Wilbar Cir
Redlands, CA 92374-6352
Phone (909) 352-2366

Other practice location 1

420 Brookside Ave
Redlands, CA 92373-4610
Phone (909) 793-2020

Other practice location 2

11234 Anderson St
Loma Linda, CA 92350-1716
Phone (909) 558-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1768176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788048000000",
    "number": "1720946684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 WILBAR CIR",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923746352",
            "telephone_number": "909-352-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 WILBAR CIR",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923746352",
            "telephone_number": "909-352-2366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Brookside Ave",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "923734610",
            "country_code": "US",
            "telephone_number": "909-793-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11234 Anderson St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923501716",
            "country_code": "US",
            "telephone_number": "909-558-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRISHAM",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-12",
        "last_updated": "2026-08-30",
        "certification_date": "2026-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "CA",
            "license": "95040134",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95040134",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.