Individual provider Active NPI

Alice Chinyere Echeta, FNP, PMHNP

  • Family Nurse Practitioner
  • Riverside, CA
National Provider Identifier
1003067141
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
560027 Issued in CA
Practice address
4960 Arlington Ave Ste B
Riverside, CA 92504-2738
Phone
(951) 341-8930
NPI assigned
Oct 7, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0808X 560027 CA
Family Nurse Practitioner 363LF0000X 560027 CA Primary

Addresses

Primary practice location

4960 Arlington Ave Ste B
Riverside, CA 92504-2738

Mailing address

10976 Bamboo CT
Fontana, CA 92337-6844
Phone (909) 201-1735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121228000414 CA Practitioner - Nurse Practitioner 7315838539 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Foothill Behavioral Health Consultants IncGroup PAC ID 9739276882, 11 clinicians

Practice addresses (Care Compare)

15434 W Sage St
Victorville, CA 92392-9708

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
560027CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Foothill Behavioral Health Consultants Inc Single Specialty CurrentSince May 1, 2021 Accepting new patients
Grow Healthcare Group PC Mental Health CurrentSince Aug 8, 2024 Accepting new patients
Destiny Home Health Agency Inc PastSince Apr 30, 2003 Accepting new patients
Neighborhood Medical Clinic of Riverside Inc Single Specialty PastSince May 23, 2005 Accepting new patients
Neighborhood Medical Clinic of Riverside Past Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

15434 W Sage St
Ste 101
Victorville, CA 92392
Phone (760) 843-0506

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1003067141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10976 BAMBOO CT",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923376844",
            "telephone_number": "909-201-1735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4960 ARLINGTON AVE STE B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925042738",
            "telephone_number": "951-341-8930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECHETA",
        "first_name": "ALICE",
        "middle_name": "CHINYERE",
        "credential": "FNP, PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-07",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "560027",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "560027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.