Humanity Center 4 Change

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Legal business name

HUMANITY CENTER 4 CHANGE

Practice address

9791 Arrow Rte
Rancho Cucamonga, CA 91730-3602

Phone

(951) 531-6785

NPI assigned

May 4, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Teresa Ethridge, DR.NPI 1669225553

Title

Psychologist/Intern

Phone

(951) 531-6785

Specialties & licenses 4

Addresses

Other names 1

• HumanityCenter4Change Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Teresa Ethridge

  • Professional Counselor
  • Loma Linda, CA
  • NPI 1669225553

  Community Health Worker

  NPD Authorized official

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

{
    "created_epoch": "1714780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735344000000",
    "number": "1679320832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 W FLORIDA AVE SPC 688",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925453822",
            "telephone_number": "951-531-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9791 ARROW RTE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303602",
            "telephone_number": "951-531-6785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMANITY CENTER 4 CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-04",
        "last_updated": "2024-12-28",
        "certification_date": "2024-12-28",
        "status": "A",
        "authorized_official_last_name": "ETHRIDGE",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "PSYCHOLOGIST/INTERN",
        "authorized_official_telephone_number": "951-531-6785",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DR."
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HumanityCenter4Change",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "HumanityCenter4Change",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Community Health Worker in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.