ELIZABETH BRUTUS (NPI# 1376929638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376929638 |
| Entity Type | Individual |
| Full Name | ELIZABETH BRUTUS |
| Credential | R.D.H.A.P. |
| Practice Address |
2623 S Andrews Ln San Bernardino CA 92408-4191 |
| Practice Telephone | 9096481985 |
| Mailing Telephone | 9096481985 |
| Enumeration Date | 2015-08-09 |
| Last Update Date | 2015-08-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 124Q00000X | Dental Hygienist | 19425 | CA | Dental Providers |
| Y | 125K00000X | Advanced Practice Dental Therapist | 585 | CA | Dental Providers |
| Street Address |
2623 S ANDREWS LN |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92408-4191 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073124681 | Valeria Armentilla Cecena | Student in an Organized Health Care Education/Training Program | 1950 Sunwest Ln., San Bernardino, CA 92408 | 2020-08-17 |
| 1588272066 | Horizon Therapy Services | Physical Therapist | 418 East Vanderbilt, San Bernardino, CA 92408 | 2020-07-21 |
| 1821627639 | Bl Anderson Medical Corporation | Emergency Medicine | 473 E Carnegie Dr., Ste 200, San Bernardino, CA 92408 | 2020-04-03 |
| 1922648104 | Infinite Hope Hospice Corp | Hospice Care, Community Based | 225 W Hospitality Ln Suite 305, San Bernardino, CA 92408 | 2020-01-15 |
| 1689210775 | Inland Empire Community Outreach Center | Counselor | 473 East Carnegie Drive, Suite 200, San Bernardino, CA 92408 | 2019-11-23 |
| 1992347801 | Care Marriage and Family Therapists, Inc. | Marriage & Family Therapist | 1881 Commercenter Drive E, Suite 232, San Bernardino, CA 92408 | 2019-10-11 |
| 1366084360 | Theraville Counseling Services, A Licensed Clinical Social Worker Corp | Social Worker | 155 W Hospitality Ln Ste 245, San Bernardino, CA 92408 | 2019-10-10 |
| 1548730419 | Adriana Alcaraz | Behavior Technician | 473 E Carnegie, Ste 200, San Bernardino, CA 92408 | 2018-12-04 |
| 1811467889 | Xavier J Molina-williams | Behavior Technician | 476 E Carnegie Drive, Ste 200, San Bernardino, CA 92408 | 2018-12-03 |
| 1780153148 | Gillian Washington | Behavior Technician | 473 E Carnegie Dr, Ste 200, Riverside, CA 92408 | 2018-11-15 |
| Find all providers in zip 92408 | ||||
| Taxonomy Code | 125K00000X |
| Grouping | Dental Providers |
| Classification | Advanced Practice Dental Therapist |
| An Advanced Practice Dental Therapist is: (1) A dental therapist who has completed additional training beyond basic dental therapy education and provides dental services in accordance with state advanced practice dental therapist laws or statutes; or (2) A dental hygienist with a graduate degree in advanced dental therapy prepared for independent and interdependent decision making and direct accountability for clinical judgment across the dental health care continuum. The individual has been authorized by the relevant state board or a tribal entity to provide services under the remote supervision of a dentist. The functions of the advanced practice dental therapist vary based on the needs of the dentist, the educational preparation of the advanced practice dental therapist and state dental practice acts and regulations. |
| Notes: Source: Summarized from Minnesota Statute 150A.106. [7/1/2012: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033550512 | Janice Katherine Coleman | Advanced Practice Dental Therapist | 395 W 24th St, 17782 Dianthus Ave Fontana Ca.92335, San Bernardino, CA 92405-3721 | 2013-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538760459 | Carlos Heriberto Quinonez | Advanced Practice Dental Therapist | 16077 Chella Dr, Hacienda Heights, CA 91745-6402 | 2020-11-06 |
| 1033753298 | Lynnette Bradley | Advanced Practice Dental Therapist | 4218 Giles Ct, Riverside, CA 92503-3154 | 2019-10-31 |
| 1598314023 | Peter Korn | Advanced Practice Dental Therapist | 11135 Rosemary Dr, Auburn, CA 95603-5945 | 2019-09-06 |
| 1154982395 | Evelyn Marie Schrager | Advanced Practice Dental Therapist | 803 E Woodhaven Ln, Fresno, CA 93720-1209 | 2019-06-27 |
| 1558828160 | Charon Moody | Advanced Practice Dental Therapist | 727 E Holborn Dr, Carson, CA 90746-2328 | 2019-03-01 |
| 1104371368 | Marie Ekins Rdhap Corp | Advanced Practice Dental Therapist | 10831 Canelo Rd, Whittier, CA 90604-1902 | 2016-08-17 |
| 1922484682 | Travis Tramel | Advanced Practice Dental Therapist | 4199 Flat Rock Dr, Suite 127, Riverside, CA 92505-7115 | 2015-08-05 |
| 1851774186 | Terri De La Pena | Advanced Practice Dental Therapist | 10011 Shaggybark Dr, Santee, CA 92071-1136 | 2015-07-06 |
| 1720470230 | Christine Jackson-bartolomei | Advanced Practice Dental Therapist | 4806 Darlington Ln, Sacramento, CA 95835-2000 | 2015-02-21 |
| 1356753826 | Megan Ellen Graff | Advanced Practice Dental Therapist | 6084 Gold Spirit St, Eastvale, CA 92880-0988 | 2014-06-02 |
| Find all providers with the same taxonomy | ||||
| City | SAN BERNARDINO |
| Zip Code | 92408 |
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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.