Individual provider Active NPI

Alexandria Selena Blain

  • Community Health Worker
  • Rialto, CA
National Provider Identifier
1043199896
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
214 N Palm Ave Ste 504
Rialto, CA 92376-5826
Phone
(909) 685-3897
NPI assigned
Aug 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X CA Primary

Addresses

Primary practice location

214 N Palm Ave Ste 504
Rialto, CA 92376-5826

Mailing address

6505 Escena St
San Bernardino, CA 92407-5121
Phone (909) 991-4377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rialto Family Health Services Inc. CurrentSince Sep 3, 2025 Accepting new patients

Locations

214 N Palm Ave
Ste 504
Rialto, CA 92376
Phone (909) 685-3897

Organizations & group practices 1

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": "1756252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1043199896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6505 ESCENA ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924075121",
            "telephone_number": "909-991-4377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 N PALM AVE STE 504",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923765826",
            "telephone_number": "909-685-3897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIN",
        "first_name": "ALEXANDRIA",
        "middle_name": "SELENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rialto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.