Organization Active NPI

Wholesome Psychiatry and Medical Services Inc

  • Psychiatry Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1346078706
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
WHOLESOME PSYCHIATRY AND MEDICAL SERVICES INC
Practice address
9431 Haven Ave Ste 100
Rancho Cucamonga, CA 91730-5879
Phone
(909) 966-5678
NPI assigned
Jul 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Authorized official

Name
Anthony Ogugu, NURSE PRACTITIONERNPI 1639413016
Title
NP
Phone
(909) 966-5678

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

9431 Haven Ave Ste 100
Rancho Cucamonga, CA 91730-5879

Mailing address

9431 Haven Ave Ste 100
Rancho Cucamonga, CA 91730-5879

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241001003433 CA Part B Supplier - Clinic/Group Practice 8123559119 Receives reassigned benefits from 2 practitioners
Practice locations: Corona, CA

National Provider Directory

National Provider Directory

Locations

1611 Pomona Rd
#109
Corona, CA 92878
Phone (909) 966-5678

1611 Pomona Rd
Ste 109
Corona, CA 92878

Practitioners & affiliated clinicians

Practitioners 5

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": "1721865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1346078706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9431 HAVEN AVE STE 100",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9431 HAVEN AVE STE 100",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305879",
            "telephone_number": "909-966-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLESOME PSYCHIATRY AND MEDICAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "OGUGU",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "909-966-5678",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "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 Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.