Devon Gleason

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

140446 Issued in CA

Practice address

17053 Foothill Blvd BLDG B
Fontana, CA 92335-3574

Phone

(909) 347-1300

NPI assigned

Apr 16, 2022

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1650067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1881337996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 S SUNWEST LN STE 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083248",
            "telephone_number": "909-252-4017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17053 FOOTHILL BLVD BLDG B",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353574",
            "telephone_number": "909-347-1300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1950 S Sunwest Ln Ste 200",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924083248",
            "country_code": "US",
            "telephone_number": "909-252-4017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLEASON",
        "first_name": "DEVON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-16",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "140446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Fontana, CA
• Providers in Fontana, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.