Individual provider Active NPI

Tamara Denise Tucker, ACNPC-AG

  • Acute Care Nurse Practitioner
  • Orange, CA
National Provider Identifier
1992150775
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95004293 Issued in CA
Practice address
101 The City Dr S
Orange, CA 92868-3201
Phone
(714) 456-7890
NPI assigned
Apr 28, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95004293 CA Primary
Acute Care Nurse Practitioner 363LA2100X AP129321 TX

Addresses

Primary practice location

101 The City Dr S
Orange, CA 92868-3201

Mailing address

1443 Roadrunner Dr
Corona, CA 92881-0710
Phone (708) 257-9539

Other practice location 1

11234 Anderson St
Loma Linda, CA 92354
Phone (708) 257-9539

Other practice location 2

19200 Jamboree Rd
Irvine, CA 92612-2570
Phone (714) 456-7002

Other practice location 3

11201 Benton St
Loma Linda, CA 92357-1000
Phone (909) 825-7084

Other practice location 4

4445 Magnolia Ave
Riverside, CA 92501-4135
Phone (562) 756-2426

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
I20180508001346 CA Practitioner - Nurse Practitioner 9537440839 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95004293CAMDAcute Care Nurse Practitioner
AP129321TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince May 2, 2018 Accepting new patients
University Surgeons of Orange a Medical Group CurrentSince Sep 2, 2025 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
El-Bershawi Medical Corp CurrentSince Aug 1, 2023 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince May 2, 2018 Accepting new patients
University of California Irvine Past Accepting new patients
Pacific Professional Surgical Group Inc Past Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

16305 Sand Canyon Ave
Ste 225
Irvine, CA 92618
Phone (949) 679-6874

11370 Anderson St
Ste 2100
Loma Linda, CA 92354
Phone (909) 558-2824

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

25845 Barton Rd
Ste F
Loma Linda, CA 92354
Phone (909) 558-2828

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26520 Cactus Ave
Ste 2021
Moreno Valley, CA 92555
Phone (951) 486-5700

28078 Baxter Rd
Murrieta, CA 92563
Phone (951) 290-4000

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

3762 Tibbetts St
Riverside, CA 92506
Phone (951) 686-2224

4234 Riverwalk Pkwy
Ste 230
Riverside, CA 92505
Phone (951) 373-5819

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

4234 Riverwalk Pkwy
Ste 120
Riverside, CA 92505
Phone (909) 418-2700

44274 George Cushman Ct
Ste 208
Temecula, CA 92592
Phone (951) 501-4200

901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779

Interoperability endpoints

  • Direct secure messaging: ttucker149056@direct.llu.edu

Organizations & group practices 7

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": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1992150775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1443 ROADRUNNER DR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928810710",
            "telephone_number": "708-257-9539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-7890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "92354",
            "country_code": "US",
            "telephone_number": "708-257-9539",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19200 Jamboree Rd",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926122570",
            "country_code": "US",
            "telephone_number": "714-456-7002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11201 Benton St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923571000",
            "country_code": "US",
            "telephone_number": "909-825-7084",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4445 Magnolia Ave",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925014135",
            "country_code": "US",
            "telephone_number": "562-756-2426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "TAMARA",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "ACNPC-AG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-28",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95004293",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP129321",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.