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

Collins Boampong

Individual provider Family Nurse Practitioner · NPI 1225449622

Collins Boampong is a Nurse Practitioner in Rancho Cucamonga, California. Qualified in 2014, 12 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
12
Licensed in
CA
In the registry since
2014
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Practice location Address checks out

10935 Terra Vista Pkwy Apt 244
Rancho Cucamonga, CA 91730-6360
Phone: (909) 944-3205
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence NP950000655 (CA)

Record details

NPI number1225449622
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 19, 2014
Last updated in NPPESOctober 19, 2020
Certification dateOctober 19, 2020
Mailing address1805 Medical Center Dr, San Bernardino, CA 92411-1217

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Providence Medical Foundation — 1465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Rancho Cucamonga