James B Entz, MFT
Individual provider Active NPI Marriage & Family Therapist · Bloomington, CA
NPI 1013055441 · NPPES record last updated Feb 11, 2022
Key facts
- NPI
- 1013055441
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- MFC 31323 (CA)
- Practice address
- 18612 Santa Ana Ave
Bloomington, CA 92316-2636 - Phone
- (909) 421-7120
- Fax
- (909) 421-7128
- NPI assigned
- Feb 1, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC 31323 | CA | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC 31323 | CA | Yes |
Addresses
Primary practice location
18612 Santa Ana Ave
Bloomington, CA 92316-2636
Mailing address
850 E Foothill Blvd
Rialto, CA 92376-5230
Phone (909) 421-9495
Other practice location 1
850 E Foothill Blvd
Rialto, CA 92376-5230
Phone (909) 421-9495
Other providers in Bloomington, CA
- Keiana Dobson
- Jennifer Doss
- Samuel Dudley
- Ryan Gabriel Elias
- Robyn Elmore
- Erick Esmenjaud D.D.S. Inc
- Lorraine Espano
- Alma Espinoza
- Hannah Nicole Esquivel
- Ettie Lee Homes, Inc
All providers in Bloomington, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.