INLAND EMPIRE AUTISM SPECTRUM DISORDER ASSESSMENT CENTER OF EXCELLENCE (NPI# 1689031528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689031528 |
| Entity Type | Organization |
| Organization Name | INLAND EMPIRE AUTISM SPECTRUM DISORDER ASSESSMENT CENTER OF EXCELLENCE |
| Practice Address |
1499 S Tippecanoe Ave Building A San Bernardino CA 92415-0024 |
| Mailing Address |
1499 S Tippecanoe Ave Bldg A San Bernardino CA 92408-2920 |
| Practice Telephone | 9097993777 |
| Mailing Telephone | 9097993777 |
| Mailing Fax Number | 9097995999 |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2019-06-13 |
| Authorized Official Name | ZACHARY DANE GINDER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9097993777 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | A118211 | CA | Other Service Providers |
| N | 174400000X | Specialist | A239458 | CA | Other Service Providers |
| N | 225X00000X | Occupational Therapist | 2683 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 103T00000X | Psychologist | PSY15160 | CA | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | PSY23181 | CA | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | PSY25134 | CA | Behavioral Health & Social Service Providers |
| N | 174400000X | Specialist | G46919 | CA | Other Service Providers |
| Y | 103G00000X | Clinical Neuropsychologist | PSY24993 | CA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 19314 Jesse Ln Ste 200, Riverside, CA 925085070 | 9097993777 | 9097995999 |
| Street Address |
1499 S TIPPECANOE AVE BUILDING A |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92415-0024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629639828 | Aura Lee Ah Kiong | Speech-Language Pathologist | 1499 S Tippecanoe Ave, San Bernardino, CA 92408-2920 | 2019-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578041042 | Karina Judith Barragan | Student in an Organized Health Care Education/Training Program | 19500 South Sunwest Lane, San Bernardino, CA 92415 | 2018-08-06 |
| 1841714839 | Layla Subhani | Marriage & Family Therapist | 780 E Gilbert Street, Bldg H, San Bernardino, CA 92415 | 2017-08-01 |
| 1023546637 | Angelica Ruiz | Marriage & Family Therapist | 900 E. Gilbert Street, Cottage 4, San Bernardino, CA 92415 | 2017-05-25 |
| 1750825030 | Jordyn Ackerman | Marriage & Family Therapist | 900 E Gilbert Street, Cottage 4, San Bernardino, CA 92415 | 2016-12-06 |
| 1083063663 | San Bernardino County Department of Public Health | Public Health or Welfare | 1505 South D Street, San Bernardino, CA 92415 | 2016-06-06 |
| 1366821233 | Jodi Cerney | Counselor | 1950 S. Sunwest Lane, Suite #200, San Bernardino, CA 92415 | 2015-05-26 |
| 1427442268 | Yessenia Cruz | Case Manager/Care Coordinator | 780 E Gilbert St Bldg H, San Bernardino, CA 92415 | 2015-03-18 |
| 1861808859 | Hector Armando Ortega | Student in an Organized Health Care Education/Training Program | 1950 S. Sunwest Ln., Rialto, CA 92415 | 2014-07-10 |
| 1437564762 | Ashlee Barker | Marriage & Family Therapist | 900 E Gilbert St. Cottage 4, San Bernardino, CA 92415 | 2014-06-25 |
| 1669802708 | County of San Bernardino | In Home Supportive Care | 784 E Hospitality Ln, San Bernardino, CA 92415 | 2013-11-26 |
| Find all providers in zip 92415 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528134186 | Joy G. Nichols | Clinical Neuropsychologist | 2195 Club Center Dr Ste A, San Bernardino, CA 92408-4162 | 2006-11-27 |
| 1972690204 | Michelle Levin-sternberg | Clinical Neuropsychologist | 325 W. Hospitality Lane, Suite 312, San Bernardino, CA 92408 | 2006-10-06 |
| 1770776510 | Vidhya Krishnamurthy | Clinical Neuropsychologist | 2195 Club Center Dr Ste A, San Bernardino, CA 92408-4162 | 2007-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407455108 | Chelsea Vilinskas | Clinical Neuropsychologist | 2624 Larkey Ln, Walnut Creek, CA 94597-2439 | 2020-10-22 |
| 1417554049 | Andrea Alioto | Clinical Neuropsychologist | 247 San Carlos Ave, Redwood City, CA 94061-3518 | 2020-10-06 |
| 1265045975 | Well Psychology, Inc. | Clinical Neuropsychologist | 3525 Del Mar Heights Rd # 1881, San Diego, CA 92130-2199 | 2020-08-24 |
| 1922618917 | Alyssa Weakley | Clinical Neuropsychologist | Uc Davis Midtown Neurology Clinic, 3160 Folsom Blvd, Sacramento, CA 95816 | 2020-08-04 |
| 1437767399 | Ni Sun-suslow | Clinical Neuropsychologist | 220 Dickinson St # B, San Diego, CA 92103-2071 | 2020-07-16 |
| 1366061707 | Talia Rose Seider | Clinical Neuropsychologist | 760 Westwood Plz Ste 37-360b, Los Angeles, CA 90024-5055 | 2020-04-15 |
| 1699394270 | Colin Jarred Gallagher | Clinical Neuropsychologist | 760 Westwood Plz # C8-854, Los Angeles, CA 90095-8353 | 2020-04-13 |
| 1649807058 | Nicholas S. Thaler Phd A Psychological Corporation | Clinical Neuropsychologist | 1526 14th St Ste 109, Santa Monica, CA 90404-3320 | 2020-03-25 |
| 1447890116 | Hussah Alkharafi | Clinical Neuropsychologist | 2720 Neilson Way # 5701, Santa Monica, CA 90405-4060 | 2020-01-10 |
| 1609414788 | Linda Rice | Clinical Neuropsychologist | 617 Bluegrass St, Simi Valley, CA 93065-5460 | 2019-12-19 |
| Find all providers with the same taxonomy | ||||
| City | SAN BERNARDINO |
| Zip Code | 92415 |
Please comment or provide details below to improve the information on INLAND EMPIRE AUTISM SPECTRUM DISORDER ASSESSMENT CENTER OF EXCELLENCE.
| 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.