Adicherla Bhavana

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

P70877 Issued in CA

Practice address

5500 University Pkwy
San Bernardino, CA 92407-2318

Phone

(909) 537-5495

NPI assigned

Jun 19, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Bhavana Adicherla Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1497598122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 UNIVERSITY PKWY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924072318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 UNIVERSITY PKWY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924072318",
            "telephone_number": "909-537-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAVANA",
        "first_name": "ADICHERLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "P70877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BHAVANA",
            "last_name": "ADICHERLA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Community/Behavioral Health Agency in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.