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ALISA LICON FNP-C
NPI 1568315836
Nurse Practitioner - Family in Upland, CA

Active since February 17, 2026PECOS Enrolled
685 N 13TH AVE, UPLAND, CA 91786(909) 981-8383 Get Directions Write a Review

NPPES record last updated: February 17, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Alisa Licon Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALISA LICON FNP-C (NPI 1568315836) is an individual family provider in Upland, California, licensed in California (95036899) and active in the NPI registry since February 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1568315836
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameALISA LICONCredential: FNP-C
Location Address685 N 13TH AVEUpland, CA 91786-4916
Mailing Address685 N 13th Ave Ste 10Upland, CA 91786-4963
Phone(909) 981-8383
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateFebruary 17, 2026
NPPES CertifiedFebruary 12, 2026
✔ NPI 1568315836 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95036899
685 N 13TH AVE, Upland, CA 91786
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alisa Licon Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID143703827
PECOS Enrollment IDI20260311001108
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91786 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROGER D. DUBER D.O., INC.
Contractor
685 N 13TH AVE, SUITE 9
UPLAND, CA 91786
San Bernardino County (909) 981-8383
DR. CARLOS R CANIZALES MD
Internal Medicine (Cardiovascular Disease)
685 N 13TH AVE, #9
UPLAND, CA 91786
San Bernardino County (909) 981-5923
LOS ANGELES CARDIOLOGY ASSOCIATES
Internal Medicine (Interventional Cardiology)
685 N 13TH AVE, SUITE 9
UPLAND, CA 91786
San Bernardino County (909) 949-3977
CHAPARRAL MEDICAL GROUP, INC.
Internal Medicine (Clinical Cardiac Electrophysiology)
685 N 13TH AVE, SUITE 11
UPLAND, CA 91786
San Bernardino County (909) 623-8796
HAMMAD O KHAN, MD, INC.
Internal Medicine (Interventional Cardiology)
685 N 13TH AVE, STE #11
UPLAND, CA 91786
San Bernardino County (909) 285-6717
CARLOS R CANIZALES MD INC
Internal Medicine (Cardiovascular Disease)
685 N 13TH AVE, SUITE 9
UPLAND, CA 91786
San Bernardino County (909) 981-5923
UNITED HEART INSTITUTE
Internal Medicine (Cardiovascular Disease)
685 N 13TH AVE
UPLAND, CA 91786
San Bernardino County (909) 500-8683
DR. ROGER DENNIS DUBER DO
Internal Medicine (Interventional Cardiology)
685 N 13TH AVE, STE 9
UPLAND, CA 91786
San Bernardino County (909) 981-8383

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alisa Licon's NPI number?

The NPI number for Alisa Licon is 1568315836. It was assigned to this individual provider in the NPPES registry on February 17, 2026.

Where is Alisa Licon located?

Alisa Licon practices at 685 N 13th Ave, Upland, CA 91786. The listed phone number is (909) 981-8383.

What is Alisa Licon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Alisa Licon enrolled in Medicare?

Yes. Alisa Licon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Alisa Licon was last updated on February 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.