MARETHA TYCE (NPI# 1083008254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083008254 |
| Entity Type | Individual |
| Full Name | MARETHA TYCE |
| Credential | NP |
| Practice Address |
742 W Highland Ave San Bernardino CA 92405-3839 |
| Practice Telephone | 9098817320 |
| Mailing Telephone | 9098817320 |
| Mailing Fax Number | 9098817329 |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2016-08-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
95002142 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1083008254 | 05 |
| Street Address |
742 W HIGHLAND AVE |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92405-3839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093789000 | Elaine Marie Gackle | Nurse Practitioner | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2006-02-15 |
| 1336789890 | Borrego Community Health Foundation | Clinic/Center | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2020-01-13 |
| 1841844990 | Karl Amparo | Nurse Practitioner | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2019-07-27 |
| 1760975825 | Ambika Ranabhat | Nurse Practitioner | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2018-06-12 |
| 1770074791 | Nomagugu Mafu | Nurse Practitioner | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2018-05-24 |
| 1366831653 | Yoggie Efendy | Nurse Practitioner | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2015-01-09 |
| 1215216965 | Oluwamuyiwa Bolonduro | Obstetrics & Gynecology | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2011-08-12 |
| 1487932372 | Hobart Leung | Internal Medicine | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2011-07-27 |
| 1265744718 | Ray Lengvilas | Pediatrics | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2010-07-12 |
| 1396914545 | Philis Denise Ransom | Obstetrics & Gynecology | 742 W Highland Ave, San Bernardino, CA 92405 | 2008-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174177497 | New Hope Transitional Living | Clinical Nurse Specialist | 1228 West 31st, San Bernardino, CA 92405 | 2019-07-25 |
| 1336647494 | Paul J Iorio | Counselor | 1669 Norht E Street, San Bernardino, CA 92405 | 2018-01-24 |
| 1609385756 | Abraham Isacc Gonzalez | Registered Nurse | 255 W 17th St, San Bernardino, CA 92405 | 2017-09-20 |
| 1962945675 | Ann Marie Monica Clark | Assisted Living Facility | 3524 Acacia Avenue, San Bernardino, CA 92405 | 2016-11-29 |
| 1801265715 | Leslie Del Toro | Counselor | 2025 N D St, San Bernardino, CA 92405 | 2015-09-21 |
| 1558797324 | Nora Escobar-mandujano | Marriage & Family Therapist | 1441 North 'd' Street, San Bernardino, CA 92405 | 2013-09-24 |
| 1295088284 | Elizabeth Rocha | Counselor | 1669 North E Street, San Bernardino, CA 92405 | 2012-10-16 |
| 1972855237 | Vanessa Kelly Gutierrez | Marriage & Family Therapist | 1669 N E Street, San Bernardino, CA 92405 | 2012-10-11 |
| 1952664021 | Mosley Counseling Center, LLC | Counselor | 2130 W. Arrowhead Ave., Suite 103c, San Bernardino, CA 92405 | 2012-06-22 |
| 1508167602 | Al Shifa Clinic Incorporated | Voluntary or Charitable | 2334 North Sierra Way, San Bernardino, CA 92405 | 2010-11-06 |
| Find all providers in zip 92405 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205378437 | Tristar Home Visit Providers Inc | Nurse Practitioner | 275 W Hospitality Ln Ste 103a, San Bernardino, CA 92408-3238 | 2016-11-04 |
| 1801282074 | Andrea Wade | Nurse Practitioner | 351 N Mountain View Ave Fas, San Bernardino, CA 92415-3115 | 2015-04-14 |
| 1912396201 | Eric Eschweiler | Nurse Practitioner | 590 N D St, San Bernardino, CA 92401-1352 | 2015-01-09 |
| 1437551561 | Priscilla Naamomo Otubuah | Nurse Practitioner | 164 W Hospitality Ln Ste 100, San Bernardino, CA 92408-3316 | 2014-09-19 |
| 1851729768 | Mercy Manaen | Nurse Practitioner | 164 W Hospitality Ln # 100, San Bernardino, CA 92408 | 2013-10-31 |
| 1841628930 | Sarita Shivakoti | Nurse Practitioner | 2150 N Waterman Ave Ste 200, San Bernardino, CA 92404-4811 | 2013-10-29 |
| 1841584778 | Sheryl Lee O. De La Cruz | Nurse Practitioner | 1850 S Waterman Ave Ste D, San Bernardino, CA 92408-2852 | 2011-06-08 |
| 1255630398 | Tracy Ann Preston | Nurse Practitioner | 1543 W 8th St, San Bernardino, CA 92411-2566 | 2011-03-15 |
| 1982905410 | Dr Ruth Tanyi, Inc | Nurse Practitioner | 577 N D St Ste 101, San Bernardino, CA 92401-1326 | 2010-11-15 |
| 1639382773 | Cathy Sampson-siriani | Nurse Practitioner | 3704 Canyon Terrace Dr, 9680 Citrus Ave, Blgd#33 Fontana, Ca 92335, San Bernardino, CA 92407-4106 | 2007-05-07 |
| Find all providers in SAN BERNARDINO | ||||
| City | SAN BERNARDINO |
| Zip Code | 92405 |
Please comment or provide details below to improve the information on MARETHA TYCE.
| 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.