Individual provider Active NPI

Yadira R. Duran Badwan

  • Community Health Worker
  • Ontario, CA
National Provider Identifier
1265249759
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
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

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1912632951MedicaidCA

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

OrganizationSpecialtyStatusNew patients
Sickle Cell Disease Foundation Community Health Worker CurrentSince Dec 22, 2024 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.

Verify at the official NPI Registry.