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

Mrs. Lilly Fong, AGNP-C

Individual provider Gerontology Nurse Practitioner · NPI 1851913115

Mrs. Lilly Fong, AGNP-C is a Nurse Practitioner in Loma Linda, California. Qualified in 2019, 7 years ago. Practices with Faculty Physicians and Surgeons of Llusm, a 1,308-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
7
Licensed in
CA
In the registry since
2020
Specialties on file
3

Practice location Address checks out

11370 Anderson St
Loma Linda, CA 92354-3450
Phone: (909) 558-2840
Show map & directions

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

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 95013904 (CA)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 95013904 (CA)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence NP95013904 (CA)

Record details

NPI number1851913115
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGNP-C
Sole proprietorNo
NPI enumeratedMay 9, 2020
Last updated in NPPESFebruary 3, 2026
Certification dateFebruary 3, 2026

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 Faculty Physicians And Surgeons Of Llusm — 1308 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Loma Linda