NPIMap

Organization Active NPI

Conscious Behavioral Health, a Medical Corporation

  • Psychiatry Physician
  • Upland, CA
National Provider Identifier
1275187346
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
CONSCIOUS BEHAVIORAL HEALTH, A MEDICAL CORPORATION
Practice address
955 W Foothill Blvd
Upland, CA 91786-3729
Phone
(909) 256-4436
Fax
(909) 256-4223
NPI assigned
Jul 27, 2019
Last updated
Sep 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Authorized official

Name
Dr. Chrystanya Adeniji, DNPNPI 1760969562
Title
DNP, Pmhnp-BC
Phone
(916) 844-4214

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Clinical Psychologist 103TC0700X
Marriage & Family Therapist 106H00000X
Nutrition Education Nutritionist 133NN1002X
Registered Nurse 163W00000X
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X
Psychiatry Physician 2084P0800X Primary
Family Nurse Practitioner 363LF0000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
Student in an Organized Health Care Education/Training Program 390200000X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

955 W Foothill Blvd
Upland, CA 91786-3729

Mailing address

1368 Oak St
Redlands, CA 92373-6868
Phone (916) 844-4214

Other practice location 1

16501 Walnut St Ste 12
Hesperia, CA 92345-3684
Phone (760) 949-1200

Other practice location 2

514 N California Ave Ste 18
Beaumont, CA 92223-2120
Phone (916) 844-4214

National Provider Directory

National Provider Directory

Locations

333 E Arrow Hwy
Unit 1607
Upland, CA 91785

955 W Foothill Blvd
Upland, CA 91786
Phone (909) 256-4436

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1564185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568246400000",
    "number": "1275187346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1368 OAK ST",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923736868",
            "telephone_number": "916-844-4214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 W FOOTHILL BLVD",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863729",
            "telephone_number": "909-256-4436",
            "fax_number": "909-256-4223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16501 Walnut St Ste 12",
            "address_purpose": "LOCATION",
            "city": "Hesperia",
            "state": "CA",
            "postal_code": "923453684",
            "country_code": "US",
            "telephone_number": "760-949-1200",
            "fax_number": "760-657-2408",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "514 N California Ave Ste 18",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "CA",
            "postal_code": "922232120",
            "country_code": "US",
            "telephone_number": "916-844-4214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CONSCIOUS BEHAVIORAL HEALTH, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-27",
        "last_updated": "2019-09-12",
        "status": "A",
        "authorized_official_last_name": "ADENIJI",
        "authorized_official_first_name": "CHRYSTANYA",
        "authorized_official_title_or_position": "DNP, PMHNP-BC",
        "authorized_official_telephone_number": "916-844-4214",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; 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.