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

Lucyana Magrietta Panjaitan, NURSEPRACTITIONER

Individual provider Nurse Practitioner · NPI 1831656578

Lucyana Magrietta Panjaitan, NURSEPRACTITIONER is a Nurse Practitioner in Riverside, California. Qualified in 2017, 9 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
9
Licensed in
CA
In the registry since
2019
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Practice location Address checks out

4500 Brockton Ave
Riverside, CA 92501-4090
Phone: (951) 276-2760
Fax: (951) 276-2960
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 95007651 (CA)

Record details

NPI number1831656578
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorYes
NPI enumeratedFebruary 28, 2019
Last updated in NPPESSeptember 26, 2023

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Riverside