Individual provider Active NPI

Keith Noonan, D.O.

  • Psychiatry Physician
  • San Bernardino, CA
National Provider Identifier
1508271982
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20A14757 Issued in CA
Practice address
303 E Vanderbilt Way
San Bernardino, CA 92415
Phone
(909) 347-1300
Fax
(909) 347-1302
NPI assigned
Jun 24, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2014020579 MO
Psychiatry Physician 2084P0800X 20A14757 CA Primary

Addresses

Primary practice location

303 E Vanderbilt Way
San Bernardino, CA 92415

Mailing address

303 E Vanderbilt Way
San Bernardino, CA 92415-0026
Phone (909) 388-0810

Other practice location 1

932 E 34th St
Joplin, MO 64804-3932
Phone (417) 347-7600

Other practice location 2

18818 US Highway 18
Apple Valley, CA 92307-2323
Phone (760) 995-8800

Other practice location 3

17053 Foothill Blvd
Fontana, CA 92335-3574
Phone (909) 347-1300

Other practice location 4

1841 E Main St
Barstow, CA 92311-3234
Phone (760) 255-5700

Other practice location 5

12188 Hesperia Rd
Victorville, CA 92395-5822
Phone (760) 477-2199

Other practice location 6

820 E Gilbert St
San Bernardino, CA 92415-0928
Phone (909) 387-7200

Other practice location 7

2940 Inland Empire Blvd
Ontario, CA 91764-4898
Phone (909) 458-1350

Other practice location 8

850 E Foothill Blvd
Rialto, CA 92376-5230
Phone (909) 421-9301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200107000431 CA Practitioner - Psychiatry 8325472939 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of San BernardinoGroup PAC ID 3870499130, 76 clinicians
Cep America - Psychiatry PCGroup PAC ID 0244522159, 93 clinicians

Practice addresses (Care Compare)

17053 Foothill Blvd
BLDG B
Fontana, CA 92335-3574
Phone (909) 347-1300

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
14757CAMDAcupuncturist
20A14757CAMDPsychiatry Physician
2014020579MOMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Bernardino Current Accepting new patients
Cep America - Psychiatry PC Psychiatry CurrentSince Sep 10, 2019 Accepting new patients
Cep America - Psychiatry PC Psychiatry Current Accepting new patients
County of San Bernardino Current Accepting new patients
County of San Bernardino CurrentSince Jan 14, 2020 Accepting new patients
Cep America - Psychiatry PC Psychiatry CurrentSince Sep 10, 2019 Accepting new patients
County of San Bernardino CurrentSince Jan 14, 2020 Accepting new patients
Valley Star Behavioral Health, Inc. Past Accepting new patients
Valley Star Behavioral Health, Inc. Past Accepting new patients

Locations

18818 US Highway 18
Apple Valley, CA 92307
Phone (760) 995-8800

1841 E Main St
Barstow, CA 92311
Phone (760) 255-5700

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

17053 Foothill Blvd
Bldg B
Fontana, CA 92335
Phone (909) 347-1300

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2940 Inland Empire Blvd
Ontario, CA 91764
Phone (909) 458-1350

850 E Foothill Blvd
Rialto, CA 92376
Phone (909) 421-9200

1400 E Church St
Santa Maria, CA 93454
Phone (805) 739-3000

303 E Vanderbilt Way
Sn Bernrdno, CA 92415
Phone (909) 388-0801

820 E Gilbert St
Sn Bernrdno, CA 92415

Interoperability endpoints

  • Direct secure messaging: knoonan138661@direct.llu.edu

Organizations & group practices 9

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": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1508271982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E VANDERBILT WAY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924150026",
            "telephone_number": "909-388-0810",
            "fax_number": "909-890-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E VANDERBILT WAY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92415",
            "telephone_number": "909-347-1300",
            "fax_number": "909-347-1302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "932 E 34th St",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648043932",
            "country_code": "US",
            "telephone_number": "417-347-7600",
            "fax_number": "417-347-9810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18818 US Highway 18",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "CA",
            "postal_code": "923072323",
            "country_code": "US",
            "telephone_number": "760-995-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17053 Foothill Blvd",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "923353574",
            "country_code": "US",
            "telephone_number": "909-347-1300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1841 E Main St",
            "address_purpose": "LOCATION",
            "city": "Barstow",
            "state": "CA",
            "postal_code": "923113234",
            "country_code": "US",
            "telephone_number": "760-255-5700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12188 Hesperia Rd",
            "address_purpose": "LOCATION",
            "city": "Victorville",
            "state": "CA",
            "postal_code": "923955822",
            "country_code": "US",
            "telephone_number": "760-477-2199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "820 E Gilbert St",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924150928",
            "country_code": "US",
            "telephone_number": "909-387-7200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2940 Inland Empire Blvd",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "CA",
            "postal_code": "917644898",
            "country_code": "US",
            "telephone_number": "909-458-1350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "850 E Foothill Blvd",
            "address_purpose": "LOCATION",
            "city": "Rialto",
            "state": "CA",
            "postal_code": "923765230",
            "country_code": "US",
            "telephone_number": "909-421-9301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOONAN",
        "first_name": "KEITH",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-24",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2014020579",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A14757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.