Individual provider Active NPI

Jeanine Jessica Gloria, AMFT, APCC

  • Marriage & Family Therapist
  • Rialto, CA
National Provider Identifier
1063115814
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
132476 Issued in CA
Practice address
1850 N Riverside Ave Ste 180
Rialto, CA 92376-8071
Phone
(909) 379-4406
Fax
(909) 440-5138
NPI assigned
Mar 22, 2023
Last updated
Mar 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 132476 CA Primary

Addresses

Primary practice location

1850 N Riverside Ave Ste 180
Rialto, CA 92376-8071

Mailing address

1084 Raven CT
Calimesa, CA 92320-4921
Phone (909) 936-7565

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
132476CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1063115814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1084 RAVEN CT",
            "city": "CALIMESA",
            "state": "CA",
            "postal_code": "923204921",
            "telephone_number": "909-936-7565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 N RIVERSIDE AVE STE 180",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923768071",
            "telephone_number": "909-379-4406",
            "fax_number": "909-440-5138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLORIA",
        "first_name": "JEANINE",
        "middle_name": "JESSICA",
        "credential": "AMFT, APCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-22",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "132476",
            "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 Mar 22, 2023; 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.