MR. IAN TERRY CROCKER (NPI# 1215217633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215217633 |
| Entity Type | Individual |
| Full Name | MR. IAN TERRY CROCKER |
| Practice Address |
9355 Opal Ave Mentone CA 92359-9605 |
| Practice Telephone | 9097055998 |
| Practice Fax Number | 9093899431 |
| Mailing Telephone | 9097055998 |
| Mailing Fax Number | 9093899431 |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2011-08-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497769715 | Ian Crocker | Radiology | 1365 Clifton Rd Ne, Suite A1300, Atlanta, GA 30322-1013 | 2006-07-29 |
| Street Address |
9355 OPAL AVE |
| City | MENTONE |
| State | CA |
| Zip Code | 92359-9605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386831295 | Winston Simms | Marriage & Family Therapist | 9355 Opal Ave, Mentone, CA 92359-9605 | 2007-09-25 |
| 1073750881 | Anthony Sanders | Counselor | 9355 Opal Ave, Mentone, CA 92359-9605 | 2009-01-15 |
| 1265610091 | Valley Star Behavioral Health, Inc. | Community/Behavioral Health | 9355 Opal Ave, Mentone, CA 92359-9605 | 2008-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275010852 | Pingkan Leilani Simauw | Case Manager/Care Coordinator | 10360 Rock St, Mentone, CA 92359 | 2018-07-25 |
| 1861676033 | Laurel Elizabeth Slater | Registered Nurse | 34346 Fishhatchery Rd, Mentone, CA 92359 | 2007-12-24 |
| 1356530786 | Lisa M Coonrod | Registered Nurse | 34452 Fish Hatchery Rd, Mentone, CA 92359-0122 | 2007-10-22 |
| 1841759768 | Christy Hart | Counselor | 1336 Wabash Ave, Mentone, CA 92359-1124 | 2019-03-19 |
| 1790923753 | Rose Garden Residential Care | Alzheimer Center (Dementia Center) | 1350 Wabash Ave, Mentone, CA 92359-1124 | 2009-01-29 |
| 1851639405 | Rose Garden Residential Operator, LLC | Assisted Living Facility | 1350 Wabash Ave, Mentone, CA 92359-1124 | 2013-01-16 |
| 1801150164 | Tania Marie Mccracken | Midwife | 1378 Turquoise Ave, Mentone, CA 92359-1257 | 2012-07-01 |
| 1033263298 | James Patrick Caley Dds | Dentist | 1856 Mentone Blvd Ste B, Mentone, CA 92359-1276 | 2007-01-23 |
| 1770803546 | Building A Generation | Early Intervention Provider Agency | 1320 Crafton Ave, Mentone, CA 92359-1318 | 2010-06-03 |
| 1710544713 | Elizabeth An Hess | Behavior Technician | 1365 Crafton Ave Apt 2092, Mentone, CA 92359-1354 | 2019-05-24 |
| Find all providers in zip 92359 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609171479 | Olivia Jamile Navarro | Counselor | 2107 Beechtree Ct, Mentone, CA 92359-1603 | 2011-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396346359 | Christina L Thomas | Counselor | 4611 Alamo Dr, San Diego, CA 92115-5907 | 2020-11-05 |
| 1801497854 | Amor Serra | Counselor | 1543 Colusa Pl, Salinas, CA 93906-2512 | 2020-11-05 |
| 1003417080 | Mary Williams | Counselor | 8032 Twin Oaks Ave, Citrus Heights, CA 95610-0510 | 2020-11-05 |
| 1487255790 | Sharon Kiesler | Counselor | 3621 Webster St, Oakland, CA 94609-2844 | 2020-11-03 |
| 1235730813 | Debrah Deans Therapy | Counselor | 1023 H St Ste B5, Sacramento, CA 95814-2815 | 2020-11-02 |
| 1417558974 | Diosa Marriage and Family Therapy PC | Counselor | 14420 Civic Dr Ste 6, Victorville, CA 92392-2384 | 2020-11-02 |
| 1669072302 | Imani Rivers | Counselor | 135 Gateway Ct, Vallejo, CA 94589-4339 | 2020-10-30 |
| 1912507021 | Lucid Lane Providers, P.C. | Counselor | 3251 Place Du Jardin, Optional, San Jose, CA 95148-9514 | 2020-10-28 |
| 1639779101 | Paula Perez | Counselor | 5882 Adobe Falls Rd, San Diego, CA 92120-4600 | 2020-10-26 |
| 1093314536 | Ryan Tyler Corbin | Counselor | 9075 Elk Grove Blvd, Elk Grove, CA 95624-2070 | 2020-10-24 |
| 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.