Individual provider Active NPI

William David Glasser, MSN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Upland, CA
National Provider Identifier
1730500620
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95003691 Issued in CA
Practice address
954 W Foothill Blvd
Upland, CA 91786-3782
Phone
(909) 946-4222
NPI assigned
Dec 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61024010 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95003691 CA Primary

Addresses

Primary practice location

954 W Foothill Blvd
Upland, CA 91786-3782

Mailing address

553 Wayland CT
Claremont, CA 91711-5001
Phone (714) 598-7038

Other practice location 1

57 W Main St Ste 260
Chehalis, WA 98532-4815
Phone (360) 795-5957

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160711002427 CA Practitioner - Nurse Practitioner 1254623382 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Foothills Psychological Services IncGroup PAC ID 9436157534, 37 clinicians

Practice addresses (Care Compare)

954 W Foothill Blvd
Suite a
Upland, CA 91786-3782
Phone (909) 946-4222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP61024010WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Psychological Services, Inc. CurrentSince May 28, 2016 Accepting new patients

Locations

13193 Central Ave
Ste 200
Chino, CA 91710
Phone (909) 902-9111

13193 Central Ave
Ste 100
Chino, CA 91710
Phone (909) 464-9675

5050 San Bernardino St
Montclair, CA 91763
Phone (909) 281-5800

1550 N Park Ave
Pomona, CA 91768
Phone (909) 623-0791

954 W Foothill Blvd
Upland, CA 91786
Phone (909) 946-5512

954 W Foothill Blvd
Ste A
Upland, CA 91786
Phone (909) 946-4222

600 N Euclid Ave
Ste 204
Upland, CA 91786
Phone (909) 379-1513

Organizations & group practices 2

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": "1387411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1730500620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "553 WAYLAND CT",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917115001",
            "telephone_number": "714-598-7038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 W FOOTHILL BLVD",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863782",
            "telephone_number": "909-946-4222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "57 W Main St Ste 260",
            "address_purpose": "LOCATION",
            "city": "Chehalis",
            "state": "WA",
            "postal_code": "985324815",
            "country_code": "US",
            "telephone_number": "360-795-5957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLASSER",
        "first_name": "WILLIAM",
        "middle_name": "DAVID",
        "credential": "MSN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-19",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61024010",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95003691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.