Individual provider Active NPI

Paris Conner

  • Marriage & Family Therapist
  • San Bernardino, CA
National Provider Identifier
1104077288
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
152437 Issued in CA
Practice address
2629 Annapolis Circle
San Bernardino, CA 92408
Phone
(909) 254-1781
NPI assigned
Oct 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 361533 CA
Marriage & Family Therapist 106H00000X 152437 CA Primary

Addresses

Primary practice location

2629 Annapolis Circle
San Bernardino, CA 92408

Mailing address

986 W Tibbot St
Rialto, CA 92377-8200
Phone (092) 731-5389

Other names 1

  • Paris Conner-Roscoe Other 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
152437CAMDMarriage & Family Therapist
361533CAMDObstetrics & Gynecology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1104077288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "986 W TIBBOT ST",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923778200",
            "telephone_number": "092-731-5389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2629 ANNAPOLIS CIRCLE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92408",
            "telephone_number": "909-254-1781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "PARIS",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-07",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "361533",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "152437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PARIS",
            "last_name": "CONNER-ROSCOE",
            "credential": "LMFT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Feb 3, 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.