Individual provider Active NPI

Rosekate Ugorji

  • Psychiatric/Mental Health Nurse Practitioner
  • Colton, CA
National Provider Identifier
1043481922
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95012684 Issued in CA
Practice address
400 N Pepper Ave
Colton, CA 92324-1801
Phone
(909) 580-1800
NPI assigned
Mar 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 578627 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95012684 CA Primary

Addresses

Primary practice location

400 N Pepper Ave
Colton, CA 92324-1801

Mailing address

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-1800

Other practice location 1

1809 W Redlands Blvd # 103
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
I20200123000926 CA Practitioner - Nurse Practitioner 7911332804 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
Ehab Yacoub MD Inc 179 clinicians
Inland Psychiatric Medical Group Inc 119 clinicians

Practice addresses (Care Compare)

1225 W 190TH St
Suite 280
Gardena, CA 90248-4305
Phone (877) 515-8113

73700 Dinah Shore Dr
Suite 106
Palm Desert, CA 92211-0815
Phone (760) 832-6352

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
578627CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Psychiatric Medical Group, Inc. Psychiatric/Mental Health CurrentSince Feb 12, 2020 Accepting new patients
Inland Psychiatric Medical Group, Inc. Psychiatric/Mental Health CurrentSince Feb 12, 2020 Accepting new patients
Ehab Yacoub MD Inc. CurrentSince May 15, 2023 Accepting new patients

Locations

1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113

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

17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929

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

1809 W Redlands Blvd
#103
Redlands, CA 92373
Phone (951) 990-0409

2033 Gateway Pl
Fl 5
San Jose, CA 95110
Phone (408) 856-9066

3031 Tisch Way
Ste 110
San Jose, CA 95128
Phone (669) 200-4619

3031 Tisch Way
San Jose, CA 95128
Phone (408) 260-0208

56970 Yucca Trl
Ste 104
Yucca Valley, CA 92284
Phone (760) 365-3711

Organizations & group practices 3

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": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1043481922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1809 W Redlands Blvd # 103",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "923738054",
            "country_code": "US",
            "telephone_number": "909-335-3026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UGORJI",
        "first_name": "ROSEKATE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-18",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "578627",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95012684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.