Individual provider Active NPI

Brent Donald Fite

  • Clinical Social Worker
  • San Bernardino, CA
National Provider Identifier
1497937023
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2080 S E St
San Bernardino, CA 92408-2706
Phone
(909) 388-9191
Fax
(909) 388-9195
NPI assigned
Dec 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

2080 S E St
San Bernardino, CA 92408-2706

Mailing address

11 Tennessee St Apt 213
Redlands, CA 92373-5426
Phone (909) 388-9191

Other identifiers 1

IdentifierTypeStateIssuer
1124100383OtherCABEHAVIOR HEALTH PROVIDER

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

Practice roles

OrganizationSpecialtyStatusNew patients
Telecare Corporation Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1497937023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 TENNESSEE ST APT 213",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735426",
            "telephone_number": "909-388-9191",
            "fax_number": "909-388-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 S E ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082706",
            "telephone_number": "909-388-9191",
            "fax_number": "909-388-9195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITE",
        "first_name": "BRENT",
        "middle_name": "DONALD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-05",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR HEALTH PROVIDER",
            "identifier": "1124100383",
            "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 Dec 5, 2007; 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.