TRAUMA AND HEALING FOUNDATION (NPI# 1629600341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629600341 |
| Entity Type | Organization |
| Organization Name | TRAUMA AND HEALING FOUNDATION |
| Practice Address |
17057 Foothill Blvd Ste 205 Fontana CA 92335-3574 |
| Practice Telephone | 9096933177 |
| Practice Fax Number | 9096933177 |
| Mailing Telephone | 9096933177 |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2020-02-11 |
| Authorized Official Name | MS. CAROL ROSE ADKISSON (CEO) |
| Authorized Official Telephone | 9096933177 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Trauma and Healing Foundation | Doing Business As Name - Organization |
| Street Address |
17057 FOOTHILL BLVD STE 205 |
| City | FONTANA |
| State | CA |
| Zip Code | 92335-3574 |
| 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 | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285240911 | Gar Industries, LLC | Counselor | 14050 Cherry Ave Ste R-1077, Fontana, CA 92337-0766 | 2020-09-18 |
| 1992261929 | Destiny Alzate | Counselor | 1467 Merrill Ave, Fontana, CA 92335 | 2019-02-14 |
| 1316411911 | Jared Willhide-james | Counselor | 14677 Merill Ave., Fontana, CA 92335 | 2019-01-16 |
| 1043750342 | Janil Shantil Frost | Counselor | 14677 Merrill Ave., Fontana, CA 92335 | 2017-03-06 |
| 1821408949 | Garran Alexander Smith | Counselor | 8014 Mango Ave, Apt F75, Fontana, CA 92336-3352 | 2014-04-28 |
| 1306054986 | David Evan Martin | Counselor | 17830 Arrow Blvd, Fontana, CA 92335-4037 | 2007-05-18 |
| 1407474554 | Brittney Lynn Quezada | Counselor | 14677 Merrill Ave, Fontana, CA 92335-4219 | 2020-07-06 |
| 1891310645 | Louie John Martinez | Counselor | 14677 Merrill Ave, Fontana, CA 92335-4219 | 2020-06-08 |
| 1275170003 | Isabel Cynthia Guerrero | Counselor | 14677 Merrill Avenue, Fontana, CA 92335 | 2019-11-27 |
| 1467915108 | Andrea Kim Myung | Counselor | 14677 Merrill Avenue, Fontana, CA 92335 | 2019-04-10 |
| 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.