TADESSE YOHANNES HAILE (NPI# 1770056194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770056194 |
| Entity Type | Individual |
| Full Name | TADESSE YOHANNES HAILE |
| Practice Address |
1604 N Pennsylvania Ave San Bernardino CA 92411-1171 |
| Practice Telephone | 9097132016 |
| Mailing Telephone | 9097132016 |
| Enumeration Date | 2019-01-08 |
| Last Update Date | 2019-01-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
1604 N PENNSYLVANIA AVE |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92411-1171 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609392729 | Berhe Group Home, Inc. | Community/Behavioral Health | 1604 N Pennsylvania Ave, San Bernardino, CA 92411-1171 | 2017-08-21 |
| 1740844687 | Daniel Smith | Counselor | 1604 N Pennsylvania Ave, San Bernardino, CA 92411-1171 | 2019-04-25 |
| 1871062091 | Rosemary Glaven | Counselor | 1604 N Pennsylvania Ave, San Bernardino, CA 92411-1171 | 2018-11-16 |
| 1295201903 | Rueben Michael Arrieta | Counselor | 1604 N Pennsylvania Ave, San Bernardino, CA 92411-1171 | 2018-10-19 |
| 1912473620 | Lia Abraham Amanios | Counselor | 1604 N Pennsylvania Ave, San Bernardino, CA 92411-1171 | 2018-10-19 |
| 1659863322 | Aaron Ramsey | Case Manager/Care Coordinator | 1604 N Pennsylvania Ave, San Bernardino, CA 92411 | 2018-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619537016 | Shaunice Renee Cox | Case Manager/Care Coordinator | 1604 Pennsylvania Street, San Bernardino, CA 92411 | 2019-06-18 |
| 1104327543 | Wilson Gomer M.d. Professional Medical Corporation | Clinic/Center | 1800 Western Ave Ste 103, San Bernardino, CA 92411 | 2018-02-21 |
| 1467883504 | Pedro Lynn Hayes | Nurse Practitioner | 1800 Medical Center Dr. #99, San Bernardono, CA 92411 | 2013-11-27 |
| 1184973505 | Maria G Villasenor Perez | Social Worker | 1002 W 7th St, San Bernardino, CA 92411 | 2012-08-30 |
| 1003140948 | Joe Mawad | Obstetrics & Gynecology | 1800 Western Ave Ste 204, San Bernardino, CA 92411 | 2009-09-24 |
| 1124255146 | Angie Bagheri Cook | Pediatrics | 565 N. Mount Vernon Ave, San Bernardino, CA 92411 | 2009-06-17 |
| 1770637365 | Paul Anthony Tenette | Pharmacist | Delta Drugs, 1666 N Medical Center Drive, San Bernadino, CA 92411 | 2007-01-22 |
| 1225117328 | Vinod Kumar Kaura | Internal Medicine | 1800 N Western Ave #303, San Bernardino, CA 92411 | 2006-11-02 |
| 1861582314 | Cecilia Talpa Quinones | Physician Assistant | 565 N. Mount Vernon Ave., San Bernardino, CA 92411 | 2006-10-13 |
| 1710075247 | Bramara Arya | Pediatrics | 1505 W. 17th Street, San Bernardino, CA 92411 | 2006-10-10 |
| Find all providers in zip 92411 | ||||
| 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 |
|---|---|---|---|---|
| 1427566207 | Ai Nhi Cong Brownbridge | Counselor | 658 E Brier Dr Ste 200, San Bernardino, CA 92408-2847 | 2018-01-16 |
| 1508388976 | Nancy Jean Shaw-fike | Counselor | 141 North Arrowhead Ave, San Bernardino, CA 92408 | 2017-07-07 |
| 1669916110 | Czarina Victoria Azzam | Counselor | 1950 Sunwest Ln San Bernardino Ca 92415, San Bernardino, CA 92415-6207 | 2016-12-16 |
| 1770034779 | Norma Ramos | Counselor | 255 N D St Ste 412, San Bernardino, CA 92401-1715 | 2016-10-14 |
| 1659749307 | Brenda Flores-greenan | Counselor | 284 S Allen St, San Bernardino, CA 92408-1525 | 2015-09-11 |
| 1366821233 | Jodi Cerney | Counselor | 1950 S. Sunwest Lane, Suite #200, San Bernardino, CA 92415 | 2015-05-26 |
| 1952664021 | Mosley Counseling Center, LLC | Counselor | 2130 W. Arrowhead Ave., Suite 103c, San Bernardino, CA 92405 | 2012-06-22 |
| 1700177987 | Cassandra M Jimenez | Counselor | 2065 W College Ave Apt 2036, San Bernardino, CA 92407-4653 | 2011-04-22 |
| 1275761744 | David Ayala | Counselor | 524 N Mountain View Ave, San Bernardino, CA 92401-1208 | 2009-06-23 |
| 1760631535 | Concepcion E Chavez | Counselor | 393 N D St, San Bernardino, CA 92418-0001 | 2008-09-16 |
| Find all providers in SAN BERNARDINO | ||||
| City | SAN BERNARDINO |
| Zip Code | 92411 |
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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.