Justin Bobila, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95029794 Issued in CA

Practice address

16020 Carrara LN
Fontana, CA 92336-4638

Phone

(951) 534-3227

Fax

(302) 564-4212

NPI assigned

Apr 16, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Optima Health CorpGroup PAC ID 3779911466, 32 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Mary Medical Center Hospital, Apple Valley, CA, CCN 050300

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GEGFAD

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.

• Optima Health Corp

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1245892066
  Medicare reassignment Care Compare group NPD
• Medi Psych Services Inc

  • Child & Adolescent Psychiatry Physician
  • Sherman Oaks, CA
  • NPI 1326665316
  Medicare reassignment
• Savanna Olsson, Pmhnp: a Professional Nursing Corporation

  • Nursing Care Agency
  • Victorville, CA
  • NPI 1942955935
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Mary Medical Center

  dba Providence St. Mary Medical Center

  • Advanced Practice Midwife
  • Apple Valley, CA
  • NPI 1043406440

  Hospital

  Care Compare affiliation
• St. Mary Medical Center

  dba Providence St. Mary Medical Center

  • General Acute Care Hospital
  • Apple Valley, CA
  • NPI 1669456299
  Care Compare affiliation
• St. Mary Medical Center

  dba Providence St. Mary Medical Center

  • General Acute Care Hospital
  • Apple Valley, CA
  • NPI 1710109186
  Care Compare affiliation

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

{
    "created_epoch": "1713225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1255185062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16020 CARRARA LN",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923364638",
            "telephone_number": "951-534-3227",
            "fax_number": "302-564-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16020 CARRARA LN",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923364638",
            "telephone_number": "951-534-3227",
            "fax_number": "302-564-4212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2261 Market St Ste 85139",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941141612",
            "country_code": "US",
            "telephone_number": "415-300-0762",
            "fax_number": "415-276-3163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOBILA",
        "first_name": "JUSTIN",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-16",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95029794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ruth E Bliss, CRNA
• Blue Arrow Non Emergency Medical Transportation
• Bobby Smith Professional Chiropractic Corporation
• Lisa Bodzio, PA-C
• Brian Boeck, PH.D, BCBA
• Boehm Dental Specialists PC (Fontana Periodontics and Implantology)
• Sara Boghosian, FNP-C
• Lauren Elaina-Emad Bolous

• Psychiatric/Mental Health Nurse Practitioner in Fontana, CA
• Providers in Fontana, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.