Individual provider Active NPI

Alisha Barbra Hendry

  • Marriage & Family Therapist
  • Fontana, CA
National Provider Identifier
1043715618
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT136316 Issued in CA
Practice address
17830 Arrow Blvd
Fontana, CA 92335
Phone
(909) 356-6439
Fax
(909) 428-6450
NPI assigned
Mar 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6879 CA
Marriage & Family Therapist 106H00000X LMFT136316 CA Primary

Addresses

Primary practice location

17830 Arrow Blvd
Fontana, CA 92335

Mailing address

17830 Arrow Blvd
Fontana, CA 92335-4037
Phone (909) 356-6439

Other practice location 1

1950 S Sunwest Ln Ste 200
San Bernardino, CA 92408
Phone (909) 252-4010

Other practice location 2

17830 Arrow Blvd
Fontana, CA 92335
Phone (909) 356-6439

Other names 1

  • Alisha Barbra Delbuono Former name

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

State licenses

LicenseStateTypeSpecialty
LMFT136316CAMDMarriage & Family Therapist
6879CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1043715618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17830 ARROW BLVD",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923354037",
            "telephone_number": "909-356-6439",
            "fax_number": "909-428-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17830 ARROW BLVD",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "92335",
            "telephone_number": "909-356-6439",
            "fax_number": "909-428-6450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1950 S Sunwest Ln Ste 200",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "92408",
            "country_code": "US",
            "telephone_number": "909-252-4010",
            "fax_number": "909-252-4055",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17830 Arrow Blvd",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "92335",
            "country_code": "US",
            "telephone_number": "909-356-6439",
            "fax_number": "909-428-6450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDRY",
        "first_name": "ALISHA",
        "middle_name": "BARBRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-27",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "6879",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT136316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALISHA",
            "last_name": "DELBUONO",
            "middle_name": "BARBRA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.