CARLOS JACOBO ADAME (NPI# 1154882769) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154882769 |
| Entity Type | Individual |
| Full Name | CARLOS JACOBO ADAME |
| Practice Address |
14677 Merrill Ave. Fontana CA 92335 |
| Mailing Address |
27747 Bahama Bay Moreno Valley CA 92555-5711 |
| Practice Telephone | 9516432340 |
| Mailing Telephone | 9092691410 |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2019-03-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 167G00000X | Licensed Psychiatric Technician | 40748 | CA | Nursing Service Providers |
| Street Address |
14677 MERRILL AVE. |
| City | FONTANA |
| State | CA |
| Zip Code | 92335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043750342 | Janil Shantil Frost | Counselor | 14677 Merrill Ave., Fontana, CA 92335 | 2017-03-06 |
| 1669023024 | Brittani Anne Nolan | Licensed Psychiatric Technician | 14677 Merrill Ave., Fontana, CA 92335 | 2019-09-26 |
| 1487206132 | Angela Lucille Navarro | Licensed Vocational Nurse | 14677 Merrill Ave., Fontana, CA 92335 | 2019-07-12 |
| 1871145797 | Sho Kitada | Licensed Psychiatric Technician | 14677 Merrill Ave., Fontana, CA 92335 | 2019-07-11 |
| 1588222574 | Alejandra Juarez-espinosa | Counselor | 14677 Merrill Ave., Fontana, CA 92335 | 2019-06-04 |
| 1245898220 | Francine Prieto-estrada | Peer Specialist | 14677 Merrill Ave., Fontana, CA 92335 | 2019-06-04 |
| 1760947865 | Jameela Amani Crosby | Counselor | 14677 Merrill Ave., Fontana, CA 91730 | 2019-02-04 |
| 1376055632 | Telecare Copration | Clinic/Center | 14677 Merrill Ave., Fontana, CA 92335 | 2017-10-26 |
| 1609392935 | Jaquelinne Gonzalez-ruiz | Counselor | 14677 Merrill Ave., Fontana, CA 92335 | 2017-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104425131 | Hossein Malakooti A Dental Corporation | Clinic/Center | 16540 Merrill Ave, Fontana, CA 92335 | 2020-10-21 |
| 1790312791 | Trevor Nguyen | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd, Building A, Fontana, CA 92335 | 2020-03-27 |
| 1184251365 | Benjamin Chang | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd., Bldg. A, Fontana, CA 92335 | 2020-03-26 |
| 1407487309 | Perla Hernandez | Licensed Vocational Nurse | 14677 Merrill Aver, Fontana, CA 92335 | 2020-01-29 |
| 1013552660 | Valencia Malone | Licensed Vocational Nurse | 14677 Merrill, Fontana, CA 92335 | 2019-11-07 |
| 1831749779 | Daniel Eric Wright | Student in an Organized Health Care Education/Training Program | 14677 Merrell Ave., Fontana, CA 92335 | 2019-09-12 |
| 1962069815 | Melissa Rivera | Licensed Vocational Nurse | 15217 San Bernardino Ave., Fontana, CA 92335 | 2019-05-28 |
| 1275199770 | Jennifer Lynn Malone | Peer Specialist | 14677 Merrall Ave, Fontana, CA 92335 | 2019-05-10 |
| 1770147894 | Noelle Chong | Registered Nurse | 14677 Merill Ave, Fontana, CA 92335 | 2019-04-24 |
| 1992261929 | Destiny Alzate | Counselor | 1467 Merrill Ave, Fontana, CA 92335 | 2019-02-14 |
| Find all providers in zip 92335 | ||||
| Taxonomy Code | 167G00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Psychiatric Technician |
| An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720354426 | Gary R Hernandez | Licensed Psychiatric Technician | 14677 Merrill Av., Fontana, CA 92335 | 2012-03-27 |
| 1063029643 | Deirdre Ervin | Licensed Psychiatric Technician | 14677 Merrill Ave, Fontana, CA 92335-4219 | 2020-09-28 |
| 1679189534 | Cierra Trevino | Licensed Psychiatric Technician | 14677 Merrill Ave, Fontana, CA 92335-4219 | 2020-09-16 |
| 1295344182 | Christina Chardell Ferdinand | Licensed Psychiatric Technician | 14677 Merrill Ave, Fontana, CA 92335-4219 | 2020-07-27 |
| 1245855071 | Amber Williams | Licensed Psychiatric Technician | 14677 Merrill Ave, Fontana, CA 92335-4219 | 2020-06-08 |
| 1417582461 | Patricia Guevara | Licensed Psychiatric Technician | 14677 Merrill Ave, Fontana, CA 92335-4219 | 2020-03-10 |
| 1669023024 | Brittani Anne Nolan | Licensed Psychiatric Technician | 14677 Merrill Ave., Fontana, CA 92335 | 2019-09-26 |
| 1013566736 | Matthew Allan Berry | Licensed Psychiatric Technician | 14677 Merrill Ave, Fontana, CA 92335 | 2019-09-05 |
| 1841843273 | Melissa Michelle Melara | Licensed Psychiatric Technician | 14677 Merrill Ave, Fontana, CA 92335 | 2019-07-24 |
| 1871145797 | Sho Kitada | Licensed Psychiatric Technician | 14677 Merrill Ave., Fontana, CA 92335 | 2019-07-11 |
| Find all providers in FONTANA | ||||
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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.