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General NPI Number Information
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NPI Number | 1801711940
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Entity Type | Individual
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Provider Name | JATONN PARHAM
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Gender | Female
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Dates
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Enumeration Date | 08/10/2026
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Last Update Date | 08/10/2026
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Provider Practice Location Address
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Address Line | 604 W 40TH ST
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City | SAN BERNARDINO
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State | CA
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Zip | 92407-3578
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Country | US
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Telephone | 909-712-9508
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Fax |
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Provider Business Mailing Address
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Address Line | 604 W 40TH ST
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City | SAN BERNARDINO
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State | CA
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Zip | 92407-3578
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Country | US
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Telephone | 909-712-9508
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number |
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State | CA
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Taxonomy #8
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State | CA
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Taxonomy #9
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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License Number State | CA
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Taxonomy #10
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | CA
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