Individual provider Active NPI

Sharilee Ann Bryant, M.D.

  • Psychiatry Physician
  • Fontana, CA
National Provider Identifier
1124344437
Registry record updated Jul 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A119077 Issued in CA
Practice address
17216 Slover Ave
Ste L
Fontana, CA 92337-7580
Phone
(909) 854-3420
NPI assigned
Apr 12, 2010
Last updated
Jul 1, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A119077 CA Primary

Addresses

Primary practice location

17216 Slover Ave
Ste L
Fontana, CA 92337-7580

Mailing address

268 W Hospitality LN Ste 400
San Bernardino, CA 92415-0026
Phone (909) 382-3105

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A119077CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Amistad Residential Treatment Center LLC Psychiatry Past Accepting new patients
La Amistad Residential Treatment Center , LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1271030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404172800000",
    "number": "1124344437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 W HOSPITALITY LN STE 400",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924150026",
            "telephone_number": "909-382-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17216 SLOVER AVE",
            "address_2": "STE L",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923377580",
            "telephone_number": "909-854-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "SHARILEE",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-12",
        "last_updated": "2014-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A119077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 1, 2014; 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.