Active NPI
Regina Bennett
- Counselor
- San Bernardino, CA
National Provider Identifier
1487972931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 600 N Arrowhead Ave Ste 300
San Bernardino, CA 92401-1148 - Phone
- (909) 522-4656
- Fax
- (909) 890-5950
- NPI assigned
- May 7, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
600 N Arrowhead Ave Ste 300
San Bernardino, CA 92401-1148
Mailing address
600 N Arrowhead Ave Ste 300
San Bernardino, CA 92401-1148
Phone (909) 522-4656
Other practice location 1
1053 N D St
San Bernardino, CA 92410-3521
Phone (909) 225-4656 ext. 5582
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487972931 | Medicaid | CA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676937600000",
"number": "1487972931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 N ARROWHEAD AVE STE 300",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924011148",
"telephone_number": "909-522-4656",
"fax_number": "909-890-5950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 N ARROWHEAD AVE STE 300",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924011148",
"telephone_number": "909-522-4656",
"fax_number": "909-890-5950"
}
],
"practiceLocations": [
{
"address_1": "1053 N D St",
"address_purpose": "LOCATION",
"city": "San Bernardino",
"state": "CA",
"postal_code": "924103521",
"country_code": "US",
"telephone_number": "909-225-4656 x5582",
"fax_number": "909-890-5950",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BENNETT",
"first_name": "REGINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-07",
"last_updated": "2023-02-21",
"certification_date": "2023-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1487972931",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.