Individual provider Active NPI

Jacquelyn Dang, D.O.

  • Psychiatry Physician
  • Ontario, CA
National Provider Identifier
1154778934
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20A16362 Issued in CA
Practice address
2940 Inland Empire Blvd
Ontario, CA 91764-4898
Phone
(909) 458-1350
NPI assigned
May 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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 20A16362 CA Primary

Addresses

Primary practice location

2940 Inland Empire Blvd
Ontario, CA 91764-4898

Mailing address

2940 Inland Empire Blvd
Ontario, CA 91764-4898

Other practice location 1

1841 E Main St
Barstow, CA 92311-3234
Phone (760) 255-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231130002610 CA Practitioner - Psychiatry 6507214533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of San BernardinoGroup PAC ID 3870499130, 76 clinicians

Practice addresses (Care Compare)

1841 E Main St
Barstow, CA 92311-3234
Phone (760) 255-5700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Bernardino Current Accepting new patients
County of San Bernardino CurrentSince Sep 16, 2023 Accepting new patients
County of San Bernardino CurrentSince Sep 16, 2023 Accepting new patients

Locations

1841 E Main St
Barstow, CA 92311
Phone (760) 255-5700

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

2940 Inland Empire Blvd
Ontario, CA 91764
Phone (909) 458-1350

303 E Vanderbilt Way
Sn Bernrdno, CA 92415
Phone (909) 388-0801

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1154778934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 INLAND EMPIRE BLVD",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917644898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 INLAND EMPIRE BLVD",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917644898",
            "telephone_number": "909-458-1350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1841 E Main St",
            "address_purpose": "LOCATION",
            "city": "Barstow",
            "state": "CA",
            "postal_code": "923113234",
            "country_code": "US",
            "telephone_number": "760-255-5700",
            "fax_number": "760-256-5092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANG",
        "first_name": "JACQUELYN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-20",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A16362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

Verify at the official NPI Registry.