Catherine Campos, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95018291 Issued in CA

Practice address

2080 S E St Ste 250
San Bernardino, CA 92408-2706

Phone

(909) 486-1207

NPI assigned

Dec 3, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Telecare Corporation

  dba Gateway To Recovery

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Diego, CA
  • NPI 1720164882
  Medicare reassignment NPD
• Telecare Corporation

  • Health Maintenance Organization
  • San Bernardino, CA
  • NPI 1770741282
  NPD (past)

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

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653177600000",
    "number": "1730847070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 S AZUSA AVE STE B-19",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917918004",
            "telephone_number": "909-486-1207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 S E ST STE 250",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082706",
            "telephone_number": "909-486-1207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPOS",
        "first_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-03",
        "last_updated": "2022-05-22",
        "certification_date": "2022-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95018291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gospha Gordon Campbell, M.D.
• Henroy Campbell
• Norine Campbell, PSYD
• Spencer James Campbell III
• Ana Estela Campos
• Diana Dolores Campos
• Erika Campos
• Jamie Campos
• Karina Guadalupe Campos
• Leticia Campos

• Psychiatric/Mental Health Nurse Practitioner in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.