Bertha M Ilongo, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95233258 Issued in CA

Practice address

720 Wood St
Eureka, CA 95501-4413

Phone

(707) 268-2990

NPI assigned

Apr 24, 2012

Last updated

May 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Beachman Psychiatry & Addiction Medical Clinic, Inc.

  • Clinic/Center
  • Eastvale, CA
  • NPI 1891588596
  Medicare reassignment NPD
• ABA Inc

  dba ABA Home Health Care

  • In Home Supportive Care Agency
  • Washington, DC
  • NPI 1114014685
  NPD (past)

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1851659171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2656 W CANYON AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234684",
            "telephone_number": "913-257-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 WOOD ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955014413",
            "telephone_number": "707-268-2990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2656 W Canyon Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921234684",
            "country_code": "US",
            "telephone_number": "913-257-1824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ILONGO",
        "first_name": "BERTHA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-24",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95233258",
            "primary": true
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95233258",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Hall Hutcheson, RN PHN
• Michael D Hutchison, PHARM.D.,CDM
• Marcie Lee Hyatt
• Ijeoma Stella Ihekwoeme, RPH
• Alyssa Ihle
• Jason Imig
• Jessica Cypress Immitt, LCSW
• Jonathan Joseph Iocco, RN
• John Walter Irvine, MD
• Caroline Isaacs, MFT

• Psychiatric/Mental Health Nurse Practitioner in Eureka, CA
• Providers in Eureka, 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 21, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.