Individual provider Active NPI

Cecile Dahlquist, FNP

  • Family Nurse Practitioner
  • San Bernardino, CA
National Provider Identifier
1972810216
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN389405 Issued in CA
Practice address
5500 University Pkwy
Csusb Student Health Center
San Bernardino, CA 92407-2318
Phone
(909) 537-5241
NPI assigned
Sep 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN389405 CA Primary

Addresses

Primary practice location

5500 University Pkwy
Csusb Student Health Center
San Bernardino, CA 92407-2318

Mailing address

PO Box 5639
Blue Jay, CA 92317-5639
Phone (909) 337-8865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5809CAMDAddiction (Substance Use Disorder) Counselor
RN389405CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
California State University San Bernardino Ap Current Accepting new patients
California State University San Bernardino Current Accepting new patients

Locations

5500 University Pkwy
San Bernardino, CA 92407
Phone (909) 537-5495

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1972810216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5639",
            "city": "BLUE JAY",
            "state": "CA",
            "postal_code": "923175639",
            "telephone_number": "909-337-8865",
            "fax_number": "909-337-3717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 UNIVERSITY PKWY",
            "address_2": "CSUSB STUDENT HEALTH CENTER",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924072318",
            "telephone_number": "909-537-5241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLQUIST",
        "first_name": "CECILE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-08",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "RN389405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.