IAN SCHULTHEISS (NPI# 1649749169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649749169 |
| Entity Type | Individual |
| Full Name | IAN SCHULTHEISS |
| Practice Address |
14677 Merril Avenue Fontana CA 92335 |
| Mailing Address |
20205 Layton St Corona CA 92881-4869 |
| Practice Telephone | 9516432335 |
| Mailing Telephone | 9518331297 |
| Enumeration Date | 2018-11-14 |
| Last Update Date | 2018-11-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
14677 MERRIL AVENUE |
| City | FONTANA |
| State | CA |
| Zip Code | 92335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174178685 | Aja Latyoa Sealey | Licensed Vocational Nurse | 14677 Merril Avenue, Fontana, CA 92335 | 2019-08-02 |
| 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 | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275199770 | Jennifer Lynn Malone | Peer Specialist | 14677 Merrall Ave, Fontana, CA 92335 | 2019-05-10 |
| 1801409081 | Terence Smith | Peer Specialist | 14677 Merrill Ave, Fontana, CA 92335-4219 | 2020-08-26 |
| 1922619493 | Ryan Jones | Peer Specialist | 14677 Merrill Ave, Fontana, CA 92335-4219 | 2020-08-10 |
| 1801412069 | Alana Guatimea Leary | Peer Specialist | 14677 Merrill Ave, Fontana, CA 92335-4219 | 2020-06-23 |
| 1386270270 | Michael Scott Mattice | Peer Specialist | 14677 Merrill Ave, Fontana, CA 92335-4219 | 2020-03-23 |
| 1043855059 | Maria Lourdes Avila | Peer Specialist | 17053 Foothill Blvd, Fontana, CA 92335-3574 | 2019-11-13 |
| 1518502525 | Gregory None Nyx | Peer Specialist | 17053 Foothill Blvd, Fontana, CA 92335-3574 | 2019-11-13 |
| 1164065041 | John Edward Prater Sr. | Peer Specialist | 14677 Merrill Av., Fontana, CA 92335 | 2019-10-23 |
| 1104486471 | Tanisha Sharee Blaze | Peer Specialist | 14677 Merrill Ave, Fontana, CA 92335 | 2019-06-18 |
| 1245898220 | Francine Prieto-estrada | Peer Specialist | 14677 Merrill Ave., Fontana, CA 92335 | 2019-06-04 |
| 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.