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

MS. Kimberly Ta

Individual provider Family Nurse Practitioner · NPI 1639839418

MS. Kimberly Ta is a Nurse Practitioner in Ontario, California. Qualified in 2021, 5 years ago. Practices with Seasons Medical Group of California Incorporated, a 12-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2021
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Practice location Address checks out

3110 E Guasti Rd Ste 315
Ontario, CA 91761-1258
Phone: (909) 942-5666
Fax: (909) 435-4202
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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 95018697 (CA)

Record details

NPI number1639839418
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 21, 2021
Last updated in NPPESJune 25, 2025
Certification dateJune 25, 2025

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 Seasons Medical Group Of California Incorporated — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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