Individual provider Active NPI

John Adeniji, N.P

  • Psychiatric/Mental Health Nurse Practitioner
  • Redlands, CA
National Provider Identifier
1003280892
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95003340 Issued in CA
Practice address
1809 W Redlands Blvd
Redlands, CA 92373-8054
Phone
(909) 335-3026
NPI assigned
Nov 17, 2015
Last updated
Oct 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95003340 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95003340 CA Primary

Addresses

Primary practice location

1809 W Redlands Blvd
Redlands, CA 92373-8054

Mailing address

1809 W Redlands Blvd
Redlands, CA 92373-8054
Phone (909) 335-3026

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
I20210209002299 CA Practitioner - Nurse Practitioner 7517372386 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2372 Sterling Ave
San Bernardino, CA 92404-4624
Phone (909) 887-6222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95003340CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Foothill Behavioral Health Consultants Inc CurrentSince May 1, 2021 Accepting new patients
Inland Psychiatric Medical Group, Inc. Psychiatric/Mental Health CurrentSince Oct 11, 2021 Accepting new patients
Inland Psychiatric Medical Group, Inc Nurse Practitioner CurrentSince Oct 11, 2021 Accepting new patients
Inland Psychiatric Medical Group, Inc. Psychiatric/Mental Health Current Accepting new patients
Temecula Valley Hospital Inc Past Accepting new patients
Dignity Health Past Accepting new patients
Inland Psychiatric Medical Group Inc Psychiatric/Mental Health PastSince Jul 31, 2023 Accepting new patients

Locations

12555 Central Ave
Ste C
Chino, CA 91710
Phone (909) 613-0100

5475 Walnut Ave
Chino, CA 91710
Phone (909) 591-6446

540 W Baseline Rd
Ste 3
Claremont, CA 91711
Phone (909) 542-0633

4160 Temescal Canyon Rd
Ste 408
Corona, CA 92883
Phone (951) 344-4451

24432 Muirlands Blvd
Ste 131
Lake Forest, CA 92630
Phone (714) 520-3000

23110 Atlantic Cir
Ste F
Moreno Valley, CA 92553
Phone (951) 243-6455

73700 Dinah Shore Dr
Ste 106
Palm Desert, CA 92211
Phone (760) 832-6352

8710 Monroe Ct
Ste 150
Rancho Cucamonga, CA 91730
Phone (909) 941-4870

1809 W Redlands Blvd
Redlands, CA 92373
Phone (909) 307-1320

2372 Sterling Ave
Sn Bernrdno, CA 92404
Phone (909) 422-8029

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

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1003280892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 W REDLANDS BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738054",
            "telephone_number": "909-335-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 W REDLANDS BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738054",
            "telephone_number": "909-335-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADENIJI",
        "first_name": "JOHN",
        "credential": "N.P",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-17",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95003340",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95003340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.