Active NPI
Tarell D Honore
- Community/Behavioral Health Agency
- Fontana, CA
National Provider Identifier
1205316882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Practice address
- 17070 Walnut Village Pkwy Ste K
Fontana, CA 92336-3285 - Phone
- (909) 320-8300
- NPI assigned
- Aug 14, 2018
- Last updated
- Aug 14, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility (Behavioral Disturbances) | 3104A0630X | NU | ||
| Community/Behavioral Health Agency | 251S00000X | NU | Primary | |
| Behavior Technician | 106S00000X | NU |
Addresses
Primary practice location
17070 Walnut Village Pkwy Ste K
Fontana, CA 92336-3285
Mailing address
PO Box 894
Desert Hot Springs, CA 92240-0894
Phone (951) 355-8826
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Key Essentials to Behavior Management, Corp | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Behavior Analyst
- Rancho Cucamonga, CA
- NPI 1639680481
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534204800000",
"number": "1205316882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 894",
"city": "DESERT HOT SPRINGS",
"state": "CA",
"postal_code": "922400894",
"telephone_number": "951-355-8826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17070 WALNUT VILLAGE PKWY STE K",
"city": "FONTANA",
"state": "CA",
"postal_code": "923363285",
"telephone_number": "909-320-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HONORE",
"first_name": "TARELL",
"middle_name": "D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-14",
"last_updated": "2018-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "3104A0630X",
"taxonomy_group": "",
"desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": false
}
],
"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 Aug 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.