Individual provider Active NPI

Jessica Dimian

  • Family Medicine Physician
  • Colton, CA
National Provider Identifier
1952808305
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
173583 Issued in CA
Practice address
400 N Pepper Ave
Colton, CA 92324-1819
Phone
(909) 580-3366
NPI assigned
Apr 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA
Family Medicine Physician 207Q00000X 173583 CA Primary

Addresses

Primary practice location

400 N Pepper Ave
Colton, CA 92324-1819

Mailing address

400 N Pepper Ave
Colton, CA 92324-1819

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211013001617 CA Practitioner - Family Practice 5597163022 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
173583CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group Family Medicine CurrentSince Sep 13, 2021 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Sep 13, 2021 Accepting new patients
Tulare Family Practice Medical Group Family Medicine Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGHIBA

Organizations & group practices 3

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": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1952808305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241819",
            "telephone_number": "909-580-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMIAN",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "173583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.