MS. ALFREDA YVONNE BANTUM (NPI# 1982823944) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982823944 |
| Entity Type | Individual |
| Full Name | MS. ALFREDA YVONNE BANTUM |
| Credential | M.S. |
| Practice Address |
1505 W Highland Ave Ste 17 San Bernardino CA 92411-1215 |
| Mailing Address |
20426 Tobira Ln Riverside CA 92508-3030 |
| Practice Telephone | 9098809130 |
| Practice Fax Number | 9094731918 |
| Mailing Telephone | 9517569637 |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2013-03-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
55644 | CA | Behavioral Health & Social Service Providers |
| N | 251S00000X | Community/Behavioral Health | CA | Agencies |
| Street Address |
1505 W HIGHLAND AVE STE 17 |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92411-1215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023237047 | Deborah Scott | Community/Behavioral Health | 1505 W Highland Ave Ste 17, San Bernardino, CA 92411-1215 | 2007-04-25 |
| 1407248297 | Knotts Family Agency | Foster Care Agency | 1505 W Highland Ave Ste 17, San Bernardino, CA 92411-1253 | 2015-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619537016 | Shaunice Renee Cox | Case Manager/Care Coordinator | 1604 Pennsylvania Street, San Bernardino, CA 92411 | 2019-06-18 |
| 1104327543 | Wilson Gomer M.d. Professional Medical Corporation | Clinic/Center | 1800 Western Ave Ste 103, San Bernardino, CA 92411 | 2018-02-21 |
| 1467883504 | Pedro Lynn Hayes | Nurse Practitioner | 1800 Medical Center Dr. #99, San Bernardono, CA 92411 | 2013-11-27 |
| 1184973505 | Maria G Villasenor Perez | Social Worker | 1002 W 7th St, San Bernardino, CA 92411 | 2012-08-30 |
| 1003140948 | Joe Mawad | Obstetrics & Gynecology | 1800 Western Ave Ste 204, San Bernardino, CA 92411 | 2009-09-24 |
| 1124255146 | Angie Bagheri Cook | Pediatrics | 565 N. Mount Vernon Ave, San Bernardino, CA 92411 | 2009-06-17 |
| 1770637365 | Paul Anthony Tenette | Pharmacist | Delta Drugs, 1666 N Medical Center Drive, San Bernadino, CA 92411 | 2007-01-22 |
| 1225117328 | Vinod Kumar Kaura | Internal Medicine | 1800 N Western Ave #303, San Bernardino, CA 92411 | 2006-11-02 |
| 1861582314 | Cecilia Talpa Quinones | Physician Assistant | 565 N. Mount Vernon Ave., San Bernardino, CA 92411 | 2006-10-13 |
| 1710075247 | Bramara Arya | Pediatrics | 1505 W. 17th Street, San Bernardino, CA 92411 | 2006-10-10 |
| Find all providers in zip 92411 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700343183 | Phillip Loving | Counselor | 5500 University Pkwy # Ce-120, San Bernardino, CA 92407-2318 | 2019-02-21 |
| 1285108555 | Sl Hobson Enterprises LLC | Counselor | 445 S Arrowhead Ave Ste C, San Bernardino, CA 92408-1335 | 2019-01-19 |
| 1730660069 | Kate E Salami | Counselor | 255 N D St Ste 400, San Bernardino, CA 92401-1715 | 2018-08-24 |
| 1659875904 | Ezekiel Moseley | Counselor | 225 W Hospitality Ln Ste 201d, San Bernardino, CA 92408-3245 | 2018-03-21 |
| 1336647494 | Paul J Iorio | Counselor | 1669 Norht E Street, San Bernardino, CA 92405 | 2018-01-24 |
| 1396262119 | Katherine Ingram | Counselor | 1905 Business Center Dr Unit 100, San Bernardino, CA 92408-3460 | 2017-08-23 |
| 1245760909 | Leslie E Brooks Jr. | Counselor | 325 W. Hospitality Ln. Ste 103, San Bernardino, CA 92408 | 2017-06-15 |
| 1417486788 | Juanita Marisol Barrientos | Counselor | 1908 Business Center Dr., San Bernardino, CA 92408 | 2017-06-08 |
| 1245768480 | Erika Sethi | Counselor | 900 E. Gilbert St, Cottage 4, San Bernardino, CA 92408-3258 | 2017-06-01 |
| 1699210591 | Stacey Ramirez | Counselor | 244 S D St, San Bernardino, CA 92401-2004 | 2016-12-30 |
| Find all providers in SAN BERNARDINO | ||||
| City | SAN BERNARDINO |
| Zip Code | 92411 |
Please comment or provide details below to improve the information on MS. ALFREDA YVONNE BANTUM.
| 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.