NPIMap

Organization Active NPI

Foothill Behavioral Health Consultants Inc

  • Psychiatry Physician
  • Victorville, CA
National Provider Identifier
1265443154
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
FOOTHILL BEHAVIORAL HEALTH CONSULTANTS INC
Practice address
16519 Victor St
Suite 406
Victorville, CA 92395-3965
Phone
(760) 843-0506
Fax
(760) 843-0507
NPI assigned
Aug 10, 2006
Last updated
Oct 24, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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

Authorized official

Name
Ikechukwu Anele Ohiaeri, M.D.NPI 1063423903
Title
Medical Director
Phone
(760) 843-0506

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

16519 Victor St
Suite 406
Victorville, CA 92395-3965

Mailing address

16519 Victor St
Suite 406
Victorville, CA 92395-3965
Phone (760) 843-0506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071106000466 CA Part B Supplier - Clinic/Group Practice 9739276882 Receives reassigned benefits from 19 practitioners
Practice locations: Rancho Cucamonga, CA; Victorville, CA

National Provider Directory

National Provider Directory

Locations

2335 S Towne Ave
Pomona, CA 91766
Phone (760) 843-0506

9220 Haven Ave
Ste 301
Rancho Cucamonga, CA 91730
Phone (760) 843-0506

14344 Cajon Ave
Ste 102
Victorville, CA 92392
Phone (760) 243-3999

15434 W Sage St
Victorville, CA 92392
Phone (760) 563-2875

15434 W Sage St
Ste 101
Victorville, CA 92392
Phone (760) 843-0506

16519 Victor St
Ste 403
Victorville, CA 92395
Phone (760) 843-0506

16519 Victor St
Ste 406
Victorville, CA 92395
Phone (760) 843-0506

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1265443154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16519 VICTOR ST",
            "address_2": "SUITE 406",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953965",
            "telephone_number": "760-843-0506",
            "fax_number": "760-843-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16519 VICTOR ST",
            "address_2": "SUITE 406",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953965",
            "telephone_number": "760-843-0506",
            "fax_number": "760-843-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILL BEHAVIORAL HEALTH CONSULTANTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "OHIAERI",
        "authorized_official_first_name": "IKECHUKWU",
        "authorized_official_middle_name": "ANELE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "760-843-0506",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.