Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Christian Custodio, FNP

Individual provider Primary Care Nurse Practitioner · NPI 1811502404

Christian Custodio, FNP is a Nurse Practitioner in Pomona, California. Qualified in 2020, 6 years ago. Practices with East Valley Community Health Center, Inc, a 50-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
6
Licensed in
CA
In the registry since
2020
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

See every abbreviation used in this directory →

Practice location Address checks out

1196 N Park Ave
Pomona, CA 91768-3027
Phone: (909) 623-4050
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence 95015354 (CA)

Record details

NPI number1811502404
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP
Sole proprietorNo
NPI enumeratedSeptember 10, 2020
Last updated in NPPESSeptember 10, 2020
Certification dateSeptember 10, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice East Valley Community Health Center, Inc. — 50 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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