Active NPI
Russell Groenheim
- School Counselor
- Fontana, CA
National Provider Identifier
1932078318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Counselor
- License
- 170247625
- Practice address
- 9680 Citrus Ave
Fontana, CA 92335-5571 - Phone
- (909) 357-5000
- Fax
- (909) 357-7699
- NPI assigned
- Nov 3, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Counselor | 101YS0200X | 170247625 | CA | Primary |
Addresses
Primary practice location
9680 Citrus Ave
Fontana, CA 92335-5571
Mailing address
9680 Citrus Ave
Fontana, CA 92335-5571
Phone (909) 357-5000
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 170247625 | CA | MD | School Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762128000000",
"number": "1932078318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9680 CITRUS AVE",
"city": "FONTANA",
"state": "CA",
"postal_code": "923355571",
"telephone_number": "909-357-5000",
"fax_number": "909-357-7699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9680 CITRUS AVE",
"city": "FONTANA",
"state": "CA",
"postal_code": "923355571",
"telephone_number": "909-357-5000",
"fax_number": "909-357-7699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROENHEIM",
"first_name": "RUSSELL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-11-03",
"last_updated": "2025-11-03",
"certification_date": "2025-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": "CA",
"license": "170247625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fontana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.