Individual provider Active NPI

Randa M Saleh

  • Marriage & Family Therapist
  • San Bernardino, CA
National Provider Identifier
1710497854
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
140645 Issued in CA
Practice address
820 E Gilbert St
San Bernardino, CA 92415-5201
Phone
(909) 387-7200
Fax
(909) 387-7717
NPI assigned
Oct 3, 2017
Last updated
Aug 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 140645 CA Primary

Addresses

Primary practice location

820 E Gilbert St
San Bernardino, CA 92415-5201

Mailing address

820 E Gilbert St
San Bernardino, CA 92415-5201
Phone (909) 387-7200

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240511000397 CA Practitioner - Mental Health Counselor 2163863812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San BernardinoGroup PAC ID 3870499130, 76 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Bernardino Current Accepting new patients
County of San Bernardino CurrentSince Apr 1, 2024 Accepting new patients
County of San Bernardino CurrentSince Apr 1, 2024 Accepting new patients

Locations

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

820 E Gilbert St
Sn Bernrdno, CA 92415
Phone (909) 386-8510

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1710497854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 E GILBERT ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924155201",
            "telephone_number": "909-387-7200",
            "fax_number": "909-387-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E GILBERT ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924155201",
            "telephone_number": "909-387-7200",
            "fax_number": "909-387-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALEH",
        "first_name": "RANDA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-03",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "140645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.