Individual provider Active NPI

Jocelyn Inacay Crisostomo, FNP

  • Family Nurse Practitioner
  • Riverside, CA
National Provider Identifier
1952791576
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95001888 Issued in CA
Practice address
491 E Alessandro Blvd
Riverside, CA 92508-6071
Phone
(186) 638-9272
NPI assigned
Feb 3, 2015
Last updated
Jun 30, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95001888 CA Primary

Addresses

Primary practice location

491 E Alessandro Blvd
Riverside, CA 92508-6071

Mailing address

31966 Cottonwood Dr
Temecula, CA 92592-4100
Phone (951) 514-8143

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
I20150326001937 CA Practitioner - Nurse Practitioner 5294052445 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95001888CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic Medical Group of Orange County Inc Family CurrentSince Jul 20, 2015 Accepting new patients
North County Endocrine Medical Group Past Accepting new patients

Locations

491 E Alessandro Blvd
Riverside, CA 92508
Phone (951) 780-1835

921 Pacific Coast Hwy
Seal Beach, CA 90740
Phone (562) 598-0473

33205 US Highway 79
Temecula, CA 92592
Phone 9513033164 ext. 8221

Organizations & group practices 2

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": "1422921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1952791576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31966 COTTONWOOD DR",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925924100",
            "telephone_number": "951-514-8143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 E ALESSANDRO BLVD",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925086071",
            "telephone_number": "186-638-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISOSTOMO",
        "first_name": "JOCELYN",
        "middle_name": "INACAY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-03",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95001888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.