Active NPI
Yadira R. Duran Badwan
- Community Health Worker
- Ontario, CA
National Provider Identifier
1265249759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 3602 Inland Empire Blvd Ste C315
Ontario, CA 91764-4986 - Phone
- (909) 743-5226
- Fax
- (909) 743-5227
- NPI assigned
- Dec 17, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | CA | Primary |
Addresses
Primary practice location
3602 Inland Empire Blvd Ste C315
Ontario, CA 91764-4986
Mailing address
3602 Inland Empire Blvd Ste C315
Ontario, CA 91764-4986
Phone (909) 743-5226
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912632951 | Medicaid | CA |
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 |
|---|---|---|---|
| Sickle Cell Disease Foundation | Community Health Worker | Current | Accepting new patients |
Locations
3602 Inland Empire Blvd
Ste C315
Ontario, CA 91764
Phone (909) 743-5226
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1734393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734393600000",
"number": "1265249759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3602 INLAND EMPIRE BLVD STE C315",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917644986",
"telephone_number": "909-743-5226",
"fax_number": "909-743-5227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3602 INLAND EMPIRE BLVD STE C315",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917644986",
"telephone_number": "909-743-5226",
"fax_number": "909-743-5227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURAN BADWAN",
"first_name": "YADIRA",
"middle_name": "R.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-12-17",
"last_updated": "2024-12-17",
"certification_date": "2024-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1912632951",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.