Individual provider Active NPI

Renee N Payne, FNP

  • Family Nurse Practitioner
  • West Covina, CA
National Provider Identifier
1972984839
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95001593 Issued in CA
Practice address
1135 S Sunset Ave Ste 401
West Covina, CA 91790-3921
Phone
(626) 732-8390
Fax
(626) 974-1522
NPI assigned
Jun 16, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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 95001593 CA Primary

Addresses

Primary practice location

1135 S Sunset Ave Ste 401
West Covina, CA 91790-3921

Mailing address

830 S Citrus Ave
Azusa, CA 91702-5942
Phone (626) 974-1441

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE)

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
I20160203001997 CA Practitioner - Nurse Practitioner 1951605468 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95001593CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Citrus Valley Physician Partners CurrentSince Jan 1, 2020 Accepting new patients
Emanate Health Medical Group CurrentSince Jan 1, 2020 Accepting new patients
Algos Inc., a Medical Corporation CurrentSince Dec 27, 2015 Accepting new patients
Emanate Health Medical Care Foundation CurrentSince Jan 1, 2024 Accepting new patients
Emanate Health Medical Group Current Accepting new patients
Algos Inc., a Medical Corporation CurrentSince Dec 27, 2015 Accepting new patients

Locations

830 S Citrus Ave
Azusa, CA 91702
Phone (626) 339-6514

14375 Pipeline Ave
Chino, CA 91710
Phone (626) 918-6544

210 W San Bernardino Rd
Covina, CA 91723
Phone (626) 858-8580

440 W Foothill Blvd
Glendora, CA 91741
Phone (626) 963-9402

415 W Carroll Ave
Fl 2
Glendora, CA 91741

1017 S Fair Oaks Ave
Pasadena, CA 91105
Phone (626) 403-6200

1115 S Sunset Ave
Ste 200
West Covina, CA 91790
Phone (626) 732-8390

1135 S Sunset Ave
Ste 401
West Covina, CA 91790
Phone (626) 732-8390

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1972984839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 S CITRUS AVE",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917025942",
            "telephone_number": "626-974-1441",
            "fax_number": "626-974-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 S SUNSET AVE STE 401",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903921",
            "telephone_number": "626-732-8390",
            "fax_number": "626-974-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "RENEE",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95001593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1135 S Sunset Ave Ste 401",
            "city": "West Covina",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917903921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.