| Foothill Behavioral Health Consultants Inc | |
|
16519 Victor St Suite 406 Victorville CA 92395-3965 | |
| (760) 843-0506 | |
| (760) 843-0507 |
| Full Name | Foothill Behavioral Health Consultants Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 16519 Victor St, Victorville, California |
| Authorized Official Name and Position | Ikechukwu Anele Ohiaeri (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7608430506 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Foothill Behavioral Health Consultants Inc 16519 Victor St Suite 406 Victorville CA 92395-3965 Ph: (760) 843-0506 | Foothill Behavioral Health Consultants Inc 16519 Victor St Suite 406 Victorville CA 92395-3965 Ph: (760) 843-0506 |
| NPI Number | 1265443154 |
|---|---|
| Provider Enumeration Date | 08/10/2006 |
| Last Update Date | 10/24/2007 |
| Medicare PECOS PAC ID | 9739276882 |
|---|---|
| Medicare Enrollment ID | O20071106000466 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265443154 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Ochuko Gregson Diamreyan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134171408 PECOS PAC ID: 5991791295 Enrollment ID: I20040422000543 |
| Provider Name | Jeanne P Newcomer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629090592 PECOS PAC ID: 1052393584 Enrollment ID: I20040607001005 |
| Provider Name | Ikechukwu A Ohiaeri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063423903 PECOS PAC ID: 0547357691 Enrollment ID: I20081010000552 |
| Provider Name | Alice C Echeta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003067141 PECOS PAC ID: 7315838539 Enrollment ID: I20121228000414 |
| Provider Name | Aubrey A King |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669577896 PECOS PAC ID: 3274625736 Enrollment ID: I20141106002492 |
| Provider Name | Susan Cole |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457782484 PECOS PAC ID: 5395000152 Enrollment ID: I20180525001382 |
| Provider Name | Linda C Njoku |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144754763 PECOS PAC ID: 4880927094 Enrollment ID: I20190603002124 |
| Provider Name | Meliza Q Kinney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316564594 PECOS PAC ID: 7214348416 Enrollment ID: I20201119000512 |
| Provider Name | Folashade Jayeoba-sampay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871192492 PECOS PAC ID: 1759795305 Enrollment ID: I20210122001388 |
| Provider Name | John O Adeniji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003280892 PECOS PAC ID: 7517372386 Enrollment ID: I20210209002299 |
| Provider Name | Myra Dina Lopez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023572583 PECOS PAC ID: 5193125706 Enrollment ID: I20210617002280 |
| Provider Name | Lynda Akoto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104451541 PECOS PAC ID: 3577953710 Enrollment ID: I20211202002032 |
| Provider Name | Savanna P Olsson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245985464 PECOS PAC ID: 8820483084 Enrollment ID: I20220324002884 |
| Provider Name | Jamie L Mishler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487883864 PECOS PAC ID: 9133509466 Enrollment ID: I20220705001837 |
| Provider Name | Jeremiah J Kroeker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669182812 PECOS PAC ID: 7911366505 Enrollment ID: I20230629001865 |
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