Active NPI
Jatonn Parham
- Assisted Living Facility
- San Bernardino, CA
National Provider Identifier
1801711940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Practice address
- 604 W 40TH St
San Bernardino, CA 92407-3578 - Phone
- (909) 712-9508
- NPI assigned
- Aug 10, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | CA | ||
| Peer Specialist | 175T00000X | CA | ||
| Community Based Hospice Care Agency | 251G00000X | CA | ||
| Community/Behavioral Health Agency | 251S00000X | CA | ||
| PACE Provider Organization | 251T00000X | CA | ||
| In Home Supportive Care Agency | 253Z00000X | CA | ||
| Adult Care Home Facility | 311ZA0620X | CA | ||
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | CA | ||
| Physical Disabilities Residential Treatment Facility | 320700000X | CA | ||
| Assisted Living Facility | 310400000X | CA | Primary |
Addresses
Primary practice location
604 W 40TH St
San Bernardino, CA 92407-3578
Mailing address
604 W 40TH St
San Bernardino, CA 92407-3578
Phone (909) 712-9508
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1786320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786320000000",
"number": "1801711940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "604 W 40TH ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924073578",
"telephone_number": "909-712-9508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "604 W 40TH ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924073578",
"telephone_number": "909-712-9508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARHAM",
"first_name": "JATONN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-08-10",
"last_updated": "2026-08-10",
"certification_date": "2026-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "251T00000X",
"taxonomy_group": "",
"desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "320600000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "320700000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Physical Disabilities",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.