Individual provider Active NPI

Monika Kaniewska, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1770949513
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95004543 Issued in CA
Practice address
11 Golden SHR Ste 350
Long Beach, CA 90802-4279
Phone
(888) 588-8995
NPI assigned
Jan 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95004543 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95004543 CA Primary

Addresses

Primary practice location

11 Golden SHR Ste 350
Long Beach, CA 90802-4279

Mailing address

15615 Alton Pkwy Ste 250
Irvine, CA 92618-7308
Phone (888) 588-8995

Other practice location 1

26800 Crown Valley Pkwy Ste 150
Mission Viejo, CA 92691-8018
Phone (888) 588-8995

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
I20170124001621 CA Practitioner - Nurse Practitioner 1456633668 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Foresight Mental HealthGroup PAC ID 6103176219, 22 clinicians
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1000 G St
Suite 125
Sacramento, CA 95814-0894
Phone (888) 588-8995

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

26800 Crown Valley Pkwy
Mission Viejo, CA 92691-6384

395 W Avenida Vista Hermosa
San Clemente, CA 92672-7720
Phone (949) 304-2117

Hospital & facility affiliations

  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95004543CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Foresight Mental Health Psychiatric/Mental Health CurrentSince May 1, 2024 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Jan 9, 2017 Accepting new patients
Providence Medical Foundation CurrentSince Jan 9, 2017 Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 400
Anaheim, CA 92805

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

11 Golden Shore
Ste 350
Long Beach, CA 90802
Phone (562) 253-7688

235 E Broadway
Ste 314
Long Beach, CA 90802
Phone (530) 240-5855

26800 Crown Valley Pkwy
Ste 150
Mission Viejo, CA 92691
Phone (949) 276-2111

26800 Crown Valley Pkwy
Ste 545
Mission Viejo, CA 92691
Phone (949) 364-1040

26800 Crown Valley Pkwy
Ste 300
Mission Viejo, CA 92691

26522 La Alameda
Ste 120
Mission Viejo, CA 92691
Phone (949) 282-1671

1000 G St
Ste 125
Sacramento, CA 95814
Phone (510) 345-4379

Interoperability endpoints

  • Direct secure messaging: mkaniewska1373960@oc.providencedirect.org
  • Direct secure messaging: monika.kaniewska.1@25119.direct.athenahealth.com

Organizations & group practices 5

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1452297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1770949513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15615 ALTON PKWY STE 250",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926187308",
            "telephone_number": "888-588-8995",
            "fax_number": "510-756-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 GOLDEN SHR STE 350",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024279",
            "telephone_number": "888-588-8995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26800 Crown Valley Pkwy Ste 150",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926918018",
            "country_code": "US",
            "telephone_number": "888-588-8995",
            "fax_number": "510-756-0812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANIEWSKA",
        "first_name": "MONIKA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-09",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95004543",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95004543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.