MRS. COURTNEY ANN WILD (NPI# 1699943175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699943175 |
| Entity Type | Individual |
| Full Name | MRS. COURTNEY ANN WILD |
| Practice Address |
164 W Hospitality Ln Suite 1-a San Bernardino CA 92408-3316 |
| Mailing Address |
1233 E 39th St San Bernardino CA 92404-1825 |
| Practice Telephone | 9098911880 |
| Practice Fax Number | 9098911888 |
| Mailing Telephone | 9095288274 |
| Enumeration Date | 2008-02-18 |
| Last Update Date | 2008-02-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
164 W HOSPITALITY LN SUITE 1-A |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92408-3316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093846198 | Augustine J Amerigo I | Chiropractor | 164 W Hospitality Ln, Ste 110, San Bernardino, CA 92408-3316 | 2007-03-08 |
| 1982016838 | Irving M. Feldkamp Dds | Dentist | 164 W Hospitality Ln, Suite 14, San Bernardino, CA 92408-3316 | 2014-05-27 |
| 1578804696 | Tri Star Medical Group & Rehab | Physical Medicine & Rehabilitation | 164 W Hospitality Ln, Ste. 16, San Bernardino, CA 92408-3316 | 2013-03-14 |
| 1104187103 | Family Planning Associates Medical Group,inc. | Clinic/Center | 164 W Hospitality Ln, 1a, San Bernardino, CA 92408-3316 | 2012-06-06 |
| 1619119328 | Rachel L Steward | Obstetrics & Gynecology | 164 W Hospitality Ln, Suite 1a, San Bernardino, CA 92408-3316 | 2009-03-26 |
| 1356516322 | Edith Herrejon | Counselor | 164 W Hospitality Ln, Ste. 4, San Bernardino, CA 92408-3316 | 2008-04-29 |
| 1902083553 | April Faith Valento | Counselor | 164 W Hospitality Ln, Suite 1a, San Bernardino, CA 92408-3316 | 2008-01-25 |
| 1629254354 | Jennifer Marlana Rohrman | Counselor | 164 W Hospitality Ln, San Bernardino, CA 92408-3316 | 2008-01-11 |
| 1780879791 | Ginger R Myren | Marriage & Family Therapist | 164 W Hospitality Ln, Suite 1-a, San Bernardino, CA 92408-3316 | 2007-09-12 |
| 1821291097 | Pui Yi Rachael Leung | Occupational Therapist | 164 W Hospitality Ln, Suite 3, San Bernardino, CA 92408-3316 | 2007-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073124681 | Valeria Armentilla Cecena | Student in an Organized Health Care Education/Training Program | 1950 Sunwest Ln., San Bernardino, CA 92408 | 2020-08-17 |
| 1588272066 | Horizon Therapy Services | Physical Therapist | 418 East Vanderbilt, San Bernardino, CA 92408 | 2020-07-21 |
| 1821627639 | Bl Anderson Medical Corporation | Emergency Medicine | 473 E Carnegie Dr., Ste 200, San Bernardino, CA 92408 | 2020-04-03 |
| 1922648104 | Infinite Hope Hospice Corp | Hospice Care, Community Based | 225 W Hospitality Ln Suite 305, San Bernardino, CA 92408 | 2020-01-15 |
| 1689210775 | Inland Empire Community Outreach Center | Counselor | 473 East Carnegie Drive, Suite 200, San Bernardino, CA 92408 | 2019-11-23 |
| 1992347801 | Care Marriage and Family Therapists, Inc. | Marriage & Family Therapist | 1881 Commercenter Drive E, Suite 232, San Bernardino, CA 92408 | 2019-10-11 |
| 1366084360 | Theraville Counseling Services, A Licensed Clinical Social Worker Corp | Social Worker | 155 W Hospitality Ln Ste 245, San Bernardino, CA 92408 | 2019-10-10 |
| 1548730419 | Adriana Alcaraz | Behavior Technician | 473 E Carnegie, Ste 200, San Bernardino, CA 92408 | 2018-12-04 |
| 1811467889 | Xavier J Molina-williams | Behavior Technician | 476 E Carnegie Drive, Ste 200, San Bernardino, CA 92408 | 2018-12-03 |
| 1780153148 | Gillian Washington | Behavior Technician | 473 E Carnegie Dr, Ste 200, Riverside, CA 92408 | 2018-11-15 |
| Find all providers in zip 92408 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935492 | Julian Ellison | Case Manager/Care Coordinator | 303 E Vandebilt Way, San Bernardino, CA 92415-0001 | 2020-09-03 |
| 1639789233 | Luis Enrique Macias | Case Manager/Care Coordinator | 26967 Beaumont Ave., Redlands Ca 92373, San Bernardino, CA 92407 | 2020-08-07 |
| 1619537016 | Shaunice Renee Cox | Case Manager/Care Coordinator | 1604 Pennsylvania Street, San Bernardino, CA 92411 | 2019-06-18 |
| 1528523065 | Leslie Gonzalez | Case Manager/Care Coordinator | 1982 W 18th St, San Bernardino, CA 92411-1059 | 2019-02-08 |
| 1326520057 | Cynthia Gutierrez | Case Manager/Care Coordinator | 237 E. Mill St., San Bernardino, CA 92408 | 2018-08-29 |
| 1457831398 | Omar Torres | Case Manager/Care Coordinator | 574 N Arrowhead Ave., San Bernardino, CA 92401 | 2018-08-20 |
| 1558841197 | Yvette Hinton | Case Manager/Care Coordinator | 431 Mackay Drive, San Bernardino, CA 92408 | 2018-08-14 |
| 1326557026 | Ruben Grajeda | Case Manager/Care Coordinator | 3561 N F St, San Bernardino, CA 92405-2120 | 2017-09-25 |
| 1225553472 | Nicole Dela Cruz | Case Manager/Care Coordinator | 720 E Gilbert Street, San Bernardino, CA 92415-0001 | 2017-08-09 |
| 1104354539 | Llesenia Aleman | Case Manager/Care Coordinator | 597 North Arrowhead Ave, San Bernardino, CA 92401 | 2017-05-30 |
| Find all providers in SAN BERNARDINO | ||||
| City | SAN BERNARDINO |
| Zip Code | 92408 |
Please comment or provide details below to improve the information on MRS. COURTNEY ANN WILD.
| 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.