Individual provider Active NPI

Blessing Chinedu-Obi

  • Clinical Social Worker
  • Rialto, CA
National Provider Identifier
1205255106
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW90139 Issued in CA
Practice address
850 E Foothill Blvd
Rialto, CA 92376-5230
Phone
(909) 421-4690
Fax
(909) 421-5650
NPI assigned
Apr 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW90139 CA Primary

Addresses

Primary practice location

850 E Foothill Blvd
Rialto, CA 92376-5230

Mailing address

850 E Foothill Blvd
Rialto, CA 92376-5230
Phone (909) 421-4690

Other practice location 1

850 E Foothill Blvd
Rialto, CA 92376-5230
Phone (909) 421-4690

Other practice location 2

21101 Dale Evans Pkwy
Apple Valley, CA 92307-9356
Phone (760) 961-6730

Other identifiers 1

IdentifierTypeStateIssuer
101YMO800XOtherCAMHS

Other names 1

  • Blessing U Chinedu-Obi Professional name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260109001340 CA Practitioner - Clinical Social Worker 7416433453 Practice locations: Moreno Valley, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Moreno Valley, CA 92555
Phone (951) 323-7431

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW90139CAMDClinical Social Worker
90139CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1205255106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 E FOOTHILL BLVD",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923765230",
            "telephone_number": "909-421-4690",
            "fax_number": "909-421-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 E FOOTHILL BLVD",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923765230",
            "telephone_number": "909-421-4690",
            "fax_number": "909-421-5650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 E Foothill Blvd",
            "address_purpose": "LOCATION",
            "city": "Rialto",
            "state": "CA",
            "postal_code": "923765230",
            "country_code": "US",
            "telephone_number": "909-421-4690",
            "fax_number": "909-421-5650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21101 Dale Evans Pkwy",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "CA",
            "postal_code": "923079356",
            "country_code": "US",
            "telephone_number": "760-961-6730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHINEDU-OBI",
        "first_name": "BLESSING",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-08",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW90139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHS",
            "identifier": "101YMO800X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BLESSING",
            "last_name": "CHINEDU-OBI",
            "middle_name": "U",
            "credential": "MSW, LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Rialto, CA

Sources for this page

Verify at the official NPI Registry.