Individual provider · Type 1 NPI

Magen Costilla

Nurse Practitioner · Moreno Valley, CA

NPI number 1023756194 Active

Practice location

26600 Cactus Ave Ste 300
Moreno Valley, CA 92555-3901

Mailing address

26600 Cactus Ave
Moreno Valley, CA 92555-3901

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XNP5017283 (CA)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1023756194

Magen Costilla's National Provider Identifier is 1023756194, issued on May 26, 2022. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Moreno Valley, CA. The record was last updated on Jun 2, 2026.