KRISTINE GRACE LEE DIZON (NPI# 1336649060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336649060 |
| Entity Type | Individual |
| Full Name | KRISTINE GRACE LEE DIZON |
| Credential | FNP-C |
| Practice Address |
110 N 4th Ave Covina CA 91723-1825 |
| Mailing Address |
14896 Oak Leaf Dr Corona CA 92880-1049 |
| Practice Telephone | 6268596400 |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2018-02-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
NP95007409 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
110 N 4TH AVE |
| City | COVINA |
| State | CA |
| Zip Code | 91723-1825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417950957 | Ranjit Alexius Cordeiro | Internal Medicine | 110 N 4th Ave, Covina, CA 91723-1825 | 2005-05-28 |
| 1063827962 | Na Yeon Han | Nurse Practitioner | 110 N 4th Ave, Covina, CA 91723-1825 | 2014-06-30 |
| 1033272992 | Ranjit A. Cordeiro Md Inc. | Internal Medicine | 110 N 4th Ave, Covina, CA 91723-1825 | 2006-12-19 |
| 1801829437 | Radhika Tulpule | Internal Medicine | 110 N 4th Ave, Covina, CA 91723-1825 | 2006-07-08 |
| 1336196864 | Radhika Tulpule Md Inc. | Internal Medicine | 110 N 4th Ave, Covina, CA 91723-1825 | 2006-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316550593 | Joshua Mercado | Behavior Technician | 210 N. Citrus Ave., Covina, CA 91723 | 2020-08-26 |
| 1578104790 | Alda Shin Shin | Behavioral Analyst | 1343 S. Grand Avenue, Suite 200, Covina, CA 91723 | 2019-09-30 |
| 1063074490 | Julia De La Torre | Student in an Organized Health Care Education/Training Program | 540 S Eremland Drive, Covina, CA 91723 | 2019-07-05 |
| 1336639368 | Counseling Solutions for Children and Families, Psychology Corporation | Community/Behavioral Health | 271 E Workman St Ste 101, Covina, CA 91723 | 2018-05-15 |
| 1669995916 | Helen Wang Le | Optometrist | 554 E San Bernardino Rd Ste 102, Covina, CA 91723 | 2017-07-19 |
| 1992242879 | Donovan Kouthiraj | Behavior Technician | 210 N Citrus Ave Ste A1, Covina, CA 91723 | 2017-01-30 |
| 1427406339 | Robinson Baron Medical Clinic | Surgery | 274 W Badillo Street, Covina, CA 91723 | 2016-06-01 |
| 1306211123 | Absolute Senior Care Services, Inc | In Home Supportive Care | 599 S Barranca Ave Ste 205, Covina, CA 91723 | 2015-12-04 |
| 1780061135 | Mohan Ckd Clinic | Internal Medicine | 171 W Cottage St, Covina, CA 91723 | 2015-05-05 |
| 1992198915 | Toshihisa Takei | Otolaryngology | 202 West College Street, Covina, CA 91723 | 2015-03-16 |
| Find all providers in zip 91723 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922658426 | Kevin Koh | Nurse Practitioner | 560 E Algrove St, Covina, CA 91723-2812 | 2019-09-17 |
| 1144781691 | Bethany Shavon Sims | Nurse Practitioner | 500 W San Bernardino Rd Ste B, Covina, CA 91722-3797 | 2019-03-27 |
| 1265901870 | Travis David Boyer | Nurse Practitioner | 1343 N Grand Ave Ste 206, Covina, CA 91724-4043 | 2018-11-13 |
| 1528547544 | Jessica Trung Le | Nurse Practitioner | 662 E Navilla Pl, Covina, CA 91723-3238 | 2018-08-09 |
| 1306352596 | Ayesha Haq | Nurse Practitioner | 315 N Third St Suite 207, Covina, CA 91723-3492 | 2017-12-25 |
| 1295116887 | Marcella Sobalvarro | Nurse Practitioner | 154 Shoppers Ln, Covina, CA 91723-3535 | 2015-06-09 |
| 1487260113 | Janet C Cruz | Nurse Practitioner | 210 W San Bernardino Rd, Covina, CA 91723-1515 | 2020-09-17 |
| 1134750474 | Benjamin Herrick | Nurse Practitioner | 210 W San Bernardino Rd, Covina, CA 91723-1515 | 2020-01-27 |
| 1801301718 | Surbhi Udeshi | Nurse Practitioner | 211 W Badillo St, Covina, CA 91723-1907 | 2017-12-14 |
| 1184174492 | Mon Tristan Atanacio | Nurse Practitioner | 500 W San Bernardino Rd, Suite B, Covina, CA 91722-3797 | 2016-10-11 |
| Find all providers in COVINA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.