Active NPI
Tabitha Obligacion, LEP
- Intellectual & Developmental Disabilities Psychologist
- Rialto, CA
National Provider Identifier
1235983156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual & Developmental Disabilities Psychologist
- License
- 4458
- Practice address
- 224 N Riverside Ave Ste D
Rialto, CA 92376-5968 - Phone
- (909) 248-4329
- NPI assigned
- Apr 16, 2024
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 4458 | CA | |
| Counseling Psychologist | 103TC1900X | 4458 | CA | |
| School Psychologist | 103TS0200X | 4458 | CA | |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 4458 | CA | Primary |
Addresses
Primary practice location
224 N Riverside Ave Ste D
Rialto, CA 92376-5968
Mailing address
PO Box 284
Rancho Cucamonga, CA 91739-0284
Phone (909) 248-4329
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 |
|---|---|---|---|
| 4458 | CA | MD | Occupational Therapy Assistant |
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.
-
- Community/Behavioral Health Agency
- Long Beach, CA
- NPI 1801713730
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713571200000",
"number": "1235983156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 284",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917390284",
"telephone_number": "909-248-4329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 N RIVERSIDE AVE STE D",
"city": "RIALTO",
"state": "CA",
"postal_code": "923765968",
"telephone_number": "909-248-4329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBLIGACION",
"first_name": "TABITHA",
"credential": "LEP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-16",
"last_updated": "2024-04-20",
"certification_date": "2024-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "CA",
"license": "4458",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CA",
"license": "4458",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "CA",
"license": "4458",
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "CA",
"license": "4458",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rialto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.