INNOVAGE HEALTH PARTNERS, INC. (NPI# 1992170575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1992170575 |
Entity Type | Organization |
Organization Name | INNOVAGE HEALTH PARTNERS, INC. |
Practice Address |
410 E Parkcenter Cir N San Bernardino CA 92408-2869 |
Practice Telephone | 9098902800 |
Practice Fax Number | 9098909615 |
Mailing Telephone | 9098902800 |
Mailing Fax Number | 9098909615 |
Enumeration Date | 2015-12-08 |
Last Update Date | 2015-12-08 |
Authorized Official Name | VANESSA D WALTON (CHIEF LEGAL OFFICER) |
Authorized Official Telephone | 7209742459 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
53735 | CA | Allopathic & Osteopathic Physicians |
Street Address |
410 E PARKCENTER CIR N |
City | SAN BERNARDINO |
State | CA |
Zip Code | 92408-2869 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750389482 | John Franklin Randolph | Family Medicine | 410 E Parkcenter Cir N, San Bernardino, CA 92408-2869 | 2005-07-07 |
1659901429 | Maricelle Ranola | Dietitian, Registered | 410 E Parkcenter Cir N, San Bernardino, CA 92408-2869 | 2020-01-21 |
1124662242 | Stembile Madakiwe | Registered Nurse | 410 E Parkcenter Cir N, San Bernardino, CA 92408-2869 | 2019-10-31 |
1588218663 | Charlisa Brothers | Nurse Practitioner | 410 E Parkcenter Cir N, San Bernardino, CA 92408-2869 | 2019-07-28 |
1871064022 | Marla Faye Downs | Occupational Therapist | 410 E Parkcenter Cir N, San Bernardino, CA 92408-2869 | 2018-12-16 |
1043781297 | Nancy Elizabeth Maurer | Occupational Therapist | 410 E Parkcenter Cir N, San Bernardino, CA 92408-2869 | 2018-12-16 |
1679058648 | Harvey Abonales | Physical Therapist | 410 E Parkcenter Cir N, San Bernardino, CA 92408-2869 | 2018-09-26 |
1902324973 | Matthew O Richards | Occupational Therapist | 410 E Parkcenter Cir N, San Bernardino, CA 92408-2869 | 2017-08-30 |
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 | 207RG0300X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Geriatric Medicine |
An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
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1427588417 | Vivacitas Medical Group PC | Internal Medicine | 1383 N Mcdowell Blvd Ste 110, Petaluma, CA 94954-1190 | 2017-06-13 |
1144616590 | Lindsey Merrihew Haddock | Internal Medicine | 4150 Clement St Bldg 1306b, San Francisco, CA 94121 | 2015-04-13 |
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City | SAN BERNARDINO |
Zip Code | 92408 |
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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.