Titian Ogo Tittle LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

TITIAN OGO TITTLE LLC

Practice address

16653 San Simeon Way
Fontana, CA 92336-1453

Phone

(424) 200-3639

Fax

(951) 330-3052

NPI assigned

Mar 7, 2022

Organization subpart

No

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

Authorized official

Name

Titian Ogo Tittle, DNP-PMHNP FNP

Title

Ceo

Phone

(951) 305-5424

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646611200000",
    "number": "1356098545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16653 SAN SIMEON WAY",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361453",
            "telephone_number": "951-305-5424",
            "fax_number": "951-330-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16653 SAN SIMEON WAY",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361453",
            "telephone_number": "424-200-3639",
            "fax_number": "951-330-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TITIAN OGO TITTLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A",
        "authorized_official_last_name": "TITTLE",
        "authorized_official_first_name": "TITIAN",
        "authorized_official_middle_name": "OGO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-305-5424",
        "authorized_official_credential": "DNP-PMHNP FNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "MyChart",
            "affiliation": "N",
            "address_1": "16653 San Simeon Way",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923361453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Primary Care Nurse Practitioner in Fontana, CA
• Providers in Fontana, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; 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.