Individual provider Active NPI

Rachael Obi

  • Psychiatric/Mental Health Nurse Practitioner
  • Fontana, CA
National Provider Identifier
1760940001
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95011263 Issued in CA
Practice address
7480 Oxford CT
Fontana, CA 92336-3522
Phone
(951) 214-9477
NPI assigned
Mar 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95011263 CA Primary

Addresses

Primary practice location

7480 Oxford CT
Fontana, CA 92336-3522

Mailing address

7480 Oxford CT
Fontana, CA 92336-3522
Phone (951) 214-9477

Other identifiers 1

IdentifierTypeStateIssuer
95011263OtherCABOARD OF REGISTERED NURSING

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
I20190711001917 CA Practitioner - Nurse Practitioner 2769717867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

162 N Santa Fe St
Hemet, CA 92543-4451
Phone (951) 652-8107

1809 W Redlands Blvd
Redlands, CA 92373-8054
Phone (909) 335-3026

2372 Sterling Ave
San Bernardino, CA 92404-4624
Phone (909) 887-6222

34675 Yucaipa Blvd
Suite 108
Yucaipa, CA 92399-4155
Phone (909) 793-9596

8710 Monroe CT
Suite 150
Rancho Cucamonga, CA 91730-4885
Phone (909) 941-4870

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Psychiatric Medical Group, Inc. Nurse Practitioner CurrentSince Jul 17, 2019 Accepting new patients
Inland Psychiatric Medical Group, Inc. Psychiatric/Mental Health CurrentSince Jul 17, 2019 Accepting new patients
Inland Psychiatric Medical Group, Inc. Psychiatric/Mental Health Current Accepting new patients
Jun R. Chiong, MD, MPH, Inc. CurrentSince Apr 1, 2020 Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients

Locations

8710 Monroe Ct
Ste 150
Rancho Cucamonga, CA 91730
Phone (909) 941-4870

1809 W Redlands Blvd
Redlands, CA 92373
Phone (909) 307-1320

414 Tennessee St
Ste Xx
Redlands, CA 92373
Phone (909) 475-7371

461 Tennessee St
Ste C
Redlands, CA 92373
Phone (909) 475-7371

2372 Sterling Ave
Sn Bernrdno, CA 92404
Phone (909) 422-8029

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3574/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1760940001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7480 OXFORD CT",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923363522",
            "telephone_number": "951-214-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7480 OXFORD CT",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923363522",
            "telephone_number": "951-214-9477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBI",
        "first_name": "RACHAEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-06",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95011263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF REGISTERED NURSING",
            "identifier": "95011263",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.