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

Kenneth Paolo Dagdag Lising, MSN, APRN, FNP-C

Individual provider Family Nurse Practitioner · NPI 1003465105

Kenneth Paolo Dagdag Lising, MSN, APRN, FNP-C is a Nurse Practitioner in Fullerton, California. Qualified in 2019, 7 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
7
Licensed in
CA
In the registry since
2019
What do these letters mean?
MSN — Master of Science in Nursing
A graduate nursing degree, usually held alongside an advanced practice licence.
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

2141 N Harbor Blvd Ste 25000
Fullerton, CA 92835-3830
Phone: (714) 626-8650
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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 95012739 (CA)

Record details

NPI number1003465105
Entity typeIndividual (Type 1)
GenderMale
Credentials MSN , APRN , FNP-C
Sole proprietorNo
NPI enumeratedSeptember 11, 2019
Last updated in NPPESNovember 11, 2021
Certification dateNovember 11, 2021

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Providence Medical Foundation — 1465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Other providers in Fullerton