Individual provider Active NPI

Justina Ozioma Obi, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • San Bernardino, CA
National Provider Identifier
1801493671
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95017391 Issued in CA
Practice address
820 E Gilbert St
San Bernardino, CA 92415-9904
Phone
(909) 387-7200
Fax
(909) 387-7717
NPI assigned
Oct 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 701154 CA
Nurse Practitioner 363L00000X 95017391 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95017391 CA Primary

Addresses

Primary practice location

820 E Gilbert St
San Bernardino, CA 92415-9904

Mailing address

7155 Citrus Avenue, #218
Fontana, CA 92336
Phone (909) 695-8828

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
I20240919001051 CA Practitioner - Nurse Practitioner 6709327687 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
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
Credentials
Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
701154CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Bernardino CurrentSince Apr 1, 2025 Accepting new patients
County of San Bernardino CurrentSince Apr 1, 2025 Accepting new patients
County of San Bernardino Current Accepting new patients
Community Health Centers of America CurrentSince Jul 9, 2024 Accepting new patients
Community Health Centers of America CurrentSince Jul 9, 2024 Accepting new patients
Good Hope Home Health Care Inc PastSince Oct 1, 2020 Accepting new patients

Locations

554 5th St
Gustine, CA 95322
Phone (209) 391-8854

5320 State Highway 49 N
Ste 1
Mariposa, CA 95338
Phone (209) 966-2225

5320 State Highway 49 N
Ste 13
Mariposa, CA 95338
Phone (209) 966-2344

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

820 E Gilbert St
Sn Bernrdno, CA 92415

Organizations & group practices 6

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": "1601856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1801493671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7155 CITRUS AVENUE, #218",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "92336",
            "telephone_number": "909-695-8828"
        },
        {
            "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": "924159904",
            "telephone_number": "909-387-7200",
            "fax_number": "909-387-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBI",
        "first_name": "JUSTINA",
        "middle_name": "OZIOMA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-05",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "701154",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95017391",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95017391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.