JENINE TITUS (NPI# 1043688161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043688161 |
| Entity Type | Individual |
| Full Name | JENINE TITUS |
| Other Name | JENINE ROBERTS |
| Practice Address |
3401 Centre Lake Dr Ste 512 Ontario CA 91761-1201 |
| Mailing Address |
4500 Brockton Ave Ste 305 Riverside CA 92501-4027 |
| Practice Telephone | 9095660445 |
| Mailing Telephone | 9516800909 |
| Enumeration Date | 2015-09-04 |
| Last Update Date | 2019-10-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
NP95002533 | CA | Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4500 Brockton Ave Ste 30, Riverside, CA 925014090 | 9516800909 |
| Street Address |
3401 CENTRE LAKE DR STE 512 |
| City | ONTARIO |
| State | CA |
| Zip Code | 91761-1201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699735191 | David Masao Hirota | Internal Medicine | 3401 Centre Lake Dr Ste 512, Ontario, CA 91761-1201 | 2006-03-27 |
| 1851876254 | Cherie Lyn Shoaf Soto | Nurse Practitioner | 3401 Centre Lake Dr Ste 512, Ontario, CA 91761-1201 | 2018-10-01 |
| 1932614203 | Ana Y. Lemus | Nurse Practitioner | 3401 Centre Lake Dr Ste 512, Ontario, CA 91761-1201 | 2017-12-08 |
| 1568977130 | Andrea Lynn Dunkel | Nurse Practitioner | 3401 Centre Lake Dr Ste 512, Ontario, CA 91761-1201 | 2017-12-05 |
| 1205282233 | Francesca Yarnall | Nurse Practitioner | 3401 Centre Lake Dr Ste 512, Ontario, CA 91761-1201 | 2016-05-09 |
| 1932583150 | Jazmyne Arteese Bosley | Registered Nurse | 3401 Centre Lake Dr Ste 512, Ontario, CA 91761-1201 | 2015-07-17 |
| 1497159818 | Kevin Bell | Physician Assistant | 3401 Centre Lake Dr Ste 512, Ontario, CA 91761-1201 | 2014-10-14 |
| 1396146882 | Ashley Diane Mccabe | Nurse Practitioner | 3401 Centre Lake Dr Ste 512, Ontario, CA 91761-1201 | 2014-09-16 |
| 1295152130 | Melissa Manion | Nurse Practitioner | 3401 Centre Lake Dr Ste 512, Ontario, CA 91761-1201 | 2014-03-27 |
| 1760808125 | Spencer Nguyen | Nurse Practitioner | 3401 Centre Lake Dr Ste 512, Ontario, CA 91761-1201 | 2014-03-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902418163 | Blue Oak Counseling Services, Inc. | Counselor | 3200 Guasti Rd #100, Ontario, CA 91761 | 2020-08-19 |
| 1578115986 | Hadel Awad | Behavior Technician | 1801 South Excise Ave, 116, Ontario, CA 91761 | 2019-07-15 |
| 1265902845 | Stephanie Escalante | Behavior Technician | 1801 S. Excise Ave. #116, Ontario, CA 91761 | 2018-11-27 |
| 1801395595 | Optimum Bio Lab Inc | Clinical Medical Laboratory | 1910 S Archibald Ave #d, Ontario, CA 91761 | 2018-02-07 |
| 1871010033 | Evelyn Esther Martinez | Case Manager/Care Coordinator | 1556 S. Sultana Ave., Ontario, CA 91761 | 2017-08-28 |
| 1750812525 | Building Bridges Christian Counseling | Marriage & Family Therapist | 3200 Guasti Road, Suite 100, Ontario, CA 91761 | 2017-03-23 |
| 1659829513 | Gregory J Musselman | Physician Assistant | 3550 E Philadelphia St Ste 150, Ontario, CA 91761 | 2016-09-20 |
| 1700332327 | Ramon Cardenas | Registered Nurse | 721 E. Banyan St., Ontario, CA 91761 | 2016-09-01 |
| 1023565660 | Breanna Gonzalez | Occupational Therapist | 3449 S. Wrangler Pl., Ontario, CA 91761 | 2016-09-01 |
| 1326491507 | Sasha Khawaja | Specialist/Technologist | 1500 So. Haven Ave, Ste 190, Ontario, CA 91761 | 2016-07-22 |
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| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.