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

Kelly Owen

Individual provider Acute Care Nurse Practitioner · NPI 1255082673

Kelly Owen is a Nurse Practitioner in Riverside, California. Qualified in 2021, 5 years ago. Practices with The Oncology Institute Ca, a Professional Corporation, a 114-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2022
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Practice location Address checks out

4646 Brockton Ave Ste 203
Riverside, CA 92506-0104
Phone: (951) 394-7028
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence NP95019278 (CA)

Record details

NPI number1255082673
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 17, 2022
Last updated in NPPESJune 5, 2023
Certification dateJune 5, 2023
Mailing address4646 Brockton Ave Ste 203, Riverside, CA 92506-0104

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice The Oncology Institute Ca, A Professional Corporation — 114 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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