Individual provider Active NPI

Adriana Cornejo, CPNP

  • Pediatrics Physician
  • Fontana, CA
National Provider Identifier
1790201283
Registry record updated Aug 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
95007142 Issued in CA
Practice address
16465 Sierra Lakes Pkwy
Fontana, CA 92336-1242
Phone
(909) 823-8000
NPI assigned
Aug 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 95007142 CA Primary

Addresses

Primary practice location

16465 Sierra Lakes Pkwy
Fontana, CA 92336-1242

Mailing address

925 Fletcher Ave
Redlands, CA 92373-5044

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
I20241018003513 CA Practitioner - Nurse Practitioner 0042550071 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Systems, Inc. CurrentSince Oct 14, 2024 Accepting new patients

Locations

22675 Alessandro Blvd
Moreno Valley, CA 92553
Phone (951) 571-2300

21801 Alessandro Blvd
Moreno Valley, CA 92553
Phone (951) 571-2300

2933 University Ave
Riverside, CA 92507
Phone (951) 224-8220

Interoperability endpoints

  • Direct secure messaging: adrianapnp.cornejo.p1@direct.chsica.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502928000000",
    "number": "1790201283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 FLETCHER AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16465 SIERRA LAKES PKWY",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361242",
            "telephone_number": "909-823-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNEJO",
        "first_name": "ADRIANA",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-17",
        "last_updated": "2017-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "95007142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.