Individual provider Active NPI

Janna Maria Casillas, PSYD

  • Psychologist
  • Fontana, CA
National Provider Identifier
1235904111
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
34680 Issued in CA
Practice address
16465 Sierra Lakes Pkwy Ste 140
Fontana, CA 92336-1242
Phone
(909) 244-9593
Fax
(833) 903-0337
NPI assigned
Nov 20, 2023
Last updated
Jun 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 34680 CA Primary

Addresses

Primary practice location

16465 Sierra Lakes Pkwy Ste 140
Fontana, CA 92336-1242

Mailing address

262 N Los Robles Ave Apt 114
Pasadena, CA 91101-1534
Phone (817) 863-1085

Other practice location 1

180 N Oakland Ave
Pasadena, CA 91101-1714
Phone (626) 584-5555

Other names 1

  • Janna Maria Schirmer Former name

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

LicenseStateTypeSpecialty
34680CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony Benigno, PSYD., Psychological Services, PC CurrentSince Jun 16, 2024 Accepting new patients
Pasadena Clinical Group, a Psychology Corporation Psychologist Past Accepting new patients

Locations

16465 Sierra Lakes Pkwy
Ste 140
Fontana, CA 92336
Phone (833) 903-0337

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1235904111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 N LOS ROBLES AVE APT 114",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011534",
            "telephone_number": "817-863-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16465 SIERRA LAKES PKWY STE 140",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361242",
            "telephone_number": "909-244-9593",
            "fax_number": "833-903-0337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 N Oakland Ave",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911011714",
            "country_code": "US",
            "telephone_number": "626-584-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASILLAS",
        "first_name": "JANNA",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-20",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "34680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANNA",
            "last_name": "SCHIRMER",
            "middle_name": "MARIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jun 11, 2024; 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.