MARY BLACK-WILLIAMS (NPI# 1114013026) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114013026 |
| Entity Type | Individual |
| Full Name | MARY BLACK-WILLIAMS |
| Credential | NP |
| Practice Address |
5050 San Bernardino St Montclair CA 91763-2326 |
| Mailing Address |
3050 E Airport Way Long Beach CA 90806-2404 |
| Practice Telephone | 9096262463 |
| Practice Fax Number | 9096246297 |
| Mailing Telephone | 5624326966 |
| Mailing Fax Number | 5624264227 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
231324 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL | RN2313240 | 01 |
| Street Address |
5050 SAN BERNARDINO ST |
| City | MONTCLAIR |
| State | CA |
| Zip Code | 91763-2326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063929420 | Ariop Psychology Group, Inc. | Psychologist | 5050 San Bernardino St, Montclair, CA 91763-2326 | 2018-01-08 |
| 1508373119 | Montclair Community Health Center | Psychologist | 5050 San Bernardino St, Montclair, CA 91763-2326 | 2018-01-04 |
| 1407306772 | Lally Medical Group, A Professional Corporation | Family Medicine | 5050 San Bernardino St, Montclair, CA 91763-2326 | 2016-10-10 |
| 1851847156 | Farid Didari Dpm PC | Podiatrist | 5050 San Bernardino St, Montclair, CA 91763-2326 | 2016-08-28 |
| 1376950857 | Justin Paul Delatore | Family Medicine | 5050 San Bernardino St, Montclair, CA 91763-2326 | 2014-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194335760 | Cho Jeon Yun Dental Partnership | Dentist | 9655 Monte Vista Ave #406, Montclair, CA 91763 | 2020-08-07 |
| 1215498811 | Above Urgent Care Center | Emergency Medicine | 8891 N. Central Ave Ste A, Montclair, CA 91763 | 2019-03-27 |
| 1467936906 | Bronislava Kroulik | Behavior Technician | 4950 San Bernardino St Ste 101, Montclair, CA 91763 | 2018-09-20 |
| 1063936110 | Monique Karina Enriquez | Licensed Vocational Nurse | 5580 Moreno St #82, Montclair, CA 91763 | 2017-07-31 |
| 1972961159 | Lacy Pinsky | Specialist/Technologist | 5035 Flora St., Montclair, CA 91763 | 2016-02-03 |
| 1912333790 | Cinta Hospice Care Inc | Hospice Care, Community Based | 5050 Palo Verde Street, Suite 101, Montclair, CA 91763 | 2013-09-24 |
| 1720334626 | Priority One Hospice, Inc. | Hospice Care, Community Based | 4959 Palo Verde St Ste 107c, Montclair, CA 91763 | 2012-07-28 |
| 1689982498 | Paulina Trujillo Perez | Counselor | 9916 Central Ave., Montclair, CA 91763 | 2010-09-15 |
| 1982846499 | Esther Phillips Agepogu | Physician Assistant | 9301 Central Ave., Montclair, CA 91763 | 2009-03-30 |
| 1568633139 | Mahin Nosrati-jahromi | Dentist | 9509 Central Ave #d, Montclair, CA 91763 | 2008-03-21 |
| Find all providers in zip 91763 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487108957 | Justine Elise Della Fave | Nurse Practitioner | 1 Normal Ave, Montclair, NJ 07043 | 2016-08-12 |
| 1104021187 | Alexandra Heitz | Nurse Practitioner | 4950 San Bernardino St Ste 106, Montclair, CA 91763-2328 | 2007-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162806 | Joan Elizabeth Kailany | Nurse Practitioner | 3344 Bartlett Ave, Rosemead, CA 91770-2773 | 2020-10-19 |
| 1447864541 | Lauren Sanchez | Nurse Practitioner | 145 Mission Ranch Blvd Ste 115, Chico, CA 95926-2296 | 2020-09-04 |
| 1417569526 | Katherine Jeanne Stafford | Nurse Practitioner | 34952 Gail Ave, Yucaipa, CA 92399-2830 | 2020-08-19 |
| 1497376875 | Monica Kistler | Nurse Practitioner | 65 N Hockett St, Porterville, CA 93257 | 2020-04-27 |
| 1942832894 | Bryonna Mathews | Nurse Practitioner | 362 Euclid Ave Apt 304, Oakland, CA 94610-3217 | 2020-02-09 |
| 1881224533 | Brittany Justine Ayala-patlan | Nurse Practitioner | 4034 S Carneros Ave, Ontario, CA 91761-3821 | 2020-01-22 |
| 1013547090 | Erin Elizabeth Murdock | Nurse Practitioner | 1986 Hummingbird Dr, Fairfield, CA 94534-6694 | 2020-01-18 |
| 1053950287 | Caitlin Rota | Nurse Practitioner | 432 S Pacific Coast Hwy, Redondo Beach, CA 90277-3735 | 2020-01-06 |
| 1578109302 | Ariel Rankin Mcdonald | Nurse Practitioner | 8920 Wilshire Blvd Ste 511, Beverly Hills, CA 90211-1949 | 2019-11-27 |
| 1093371478 | Fion Tai | Nurse Practitioner | 279 Tustin Field Dr, Tustin, CA 92782-6523 | 2019-05-12 |
| Find all providers with the same taxonomy | ||||
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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.