Individual provider Active NPI

Tanya Marie Childress

  • Rehabilitation Practitioner
  • San Bernardino, CA
National Provider Identifier
1093840134
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
572 N Arrowhead Ave
San Bernardino, CA 92401-1251
Phone
(909) 659-5834
NPI assigned
Feb 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Rehabilitation Practitioner 225400000X CA Primary
Community Health Worker 172V00000X

Addresses

Primary practice location

572 N Arrowhead Ave
San Bernardino, CA 92401-1251

Mailing address

572 N Arrowhead Ave
San Bernardino, CA 92401-1251
Phone (909) 659-5834

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

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1093840134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "572 N ARROWHEAD AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011251",
            "telephone_number": "909-659-5834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "572 N ARROWHEAD AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011251",
            "telephone_number": "909-659-5834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDRESS",
        "first_name": "TANYA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2026; 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.