Individual provider Active NPI

Douglas Chhay, CHW

  • Community Health Worker
  • San Bernardino, CA
National Provider Identifier
1154033090
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
233 E 17TH St Apt 91
San Bernardino, CA 92404-5064
Phone
(909) 383-0164
NPI assigned
Dec 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

233 E 17TH St Apt 91
San Bernardino, CA 92404-5064

Mailing address

233 E 17TH St Apt 91
San Bernardino, CA 92404-5064
Phone (909) 383-0164

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": "1671667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1154033090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 E 17TH ST APT 91",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045064",
            "telephone_number": "909-383-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 E 17TH ST APT 91",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045064",
            "telephone_number": "909-383-0164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHHAY",
        "first_name": "DOUGLAS",
        "credential": "CHW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-22",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Dec 22, 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.