Individual provider Active NPI

Jahmel Dior Rover

  • Mental Health Counselor
  • San Bernardino, CA
National Provider Identifier
1962804807
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
89947 Issued in CA
Practice address
600 N Arrowhead Ave Ste 300
San Bernardino, CA 92401-1148
Phone
(909) 763-5800
Fax
(909) 882-1282
NPI assigned
Sep 23, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 89947 CA Primary

Addresses

Primary practice location

600 N Arrowhead Ave Ste 300
San Bernardino, CA 92401-1148

Mailing address

600 N Arrowhead Ave Ste 300
San Bernardino, CA 92401-1148
Phone (909) 763-5800

Other identifiers 1

IdentifierTypeStateIssuer
1124100383MedicaidCA

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": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1962804807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N ARROWHEAD AVE STE 300",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011148",
            "telephone_number": "909-763-5800",
            "fax_number": "909-882-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N ARROWHEAD AVE STE 300",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011148",
            "telephone_number": "909-763-5800",
            "fax_number": "909-882-1282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROVER",
        "first_name": "JAHMEL",
        "middle_name": "DIOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-23",
        "last_updated": "2021-11-04",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "89947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124100383",
            "state": "CA"
        }
    ],
    "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 Nov 4, 2021; 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.