Active NPI
Nosheen Samuel
- Marriage & Family Therapist
- San Bernardino, CA
National Provider Identifier
1154528461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 46426
- Practice address
- 572 N Arrowhead Ave
San Bernardino, CA 92401-1251 - Phone
- (909) 266-2775
- Fax
- (909) 266-2790
- NPI assigned
- Jun 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 46426 | CA | Primary |
| Marriage & Family Therapist | 106H00000X | 45170 | CA |
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) 266-2775
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4015 | Other | CA | SIMON STAFF NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 45170 | CA | MD | Marriage & Family Therapist |
| 46426 | CA | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610841600000",
"number": "1154528461",
"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": "909-266-2775",
"fax_number": "909-266-2790"
},
{
"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": "909-266-2775",
"fax_number": "909-266-2790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUEL",
"first_name": "NOSHEEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-29",
"last_updated": "2021-01-17",
"certification_date": "2021-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "46426",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "45170",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SIMON STAFF NUMBER",
"identifier": "4015",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
- Samuel a. Bolivar, MD Inc
- Samuel J Roth, M.D., Apc
- Samuel M Sepuya MD. Inc
- Samuel Sepuya M.D. Corporation
- Alexandra Samuel-Sturgess
- San Bernardino Anesthesia Medical Group, Inc.
- San Bernardino Care Company
- San Bernardino City Unified School District
- San Bernardino City Usd
- San Bernardino Convalescent Operations Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.