1. Home
  2. Directory
  3. California
  4. Fontana
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

MATTHEW ALLAN BERGENDAHL JR.
NPI 1417650268
Student in an Organized Health Care Education/Training Program in Fontana, CA

Active since March 22, 2023PECOS Enrolled
17234 VALLEY BLVD, BUILDING A, FONTANA, CA 92335(657) 248-9435 Get Directions Write a Review

NPPES record last updated: September 28, 2023. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Matthew Allan Bergendahl Jr. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MATTHEW ALLAN BERGENDAHL JR. (NPI 1417650268) is an individual student in an organized health care education/training program in Fontana, California and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417650268
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMATTHEW ALLAN BERGENDAHL JR.
Location Address17234 VALLEY BLVD, BUILDING AFontana, CA 92335-6720
Mailing Address17234 Valley Blvd, Building AFontana, CA 92335-6720
Phone(657) 248-9435
Sole ProprietorNo
Enumeration DateMarch 22, 2023
Last NPPES UpdateSeptember 28, 2023
NPPES CertifiedMarch 20, 2023
✔ NPI 1417650268 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
17234 VALLEY BLVD, Fontana, CA 92335
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Matthew Allan Bergendahl Jr. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VENKATA SAITEJA PAMIDIMUKKALA DO
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD
FONTANA, CA 92335
San Bernardino County (925) 819-4476
JAMI WANG DO
Psychiatry & Neurology (Psychiatry)
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
San Bernardino County (909) 427-5679
URVASHI SINGH
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
San Bernardino County (909) 427-5679
GENISE URSIE JADE BROWNE MD
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
San Bernardino County (407) 309-0538
DR. ALEXANDER JASON BRESSLER DO
Family Medicine
17234 VALLEY BLVD
FONTANA, CA 92335
San Bernardino County (909) 427-5084
DR. GREISHKA NICOLE CORDERO BAEZ MD
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
San Bernardino County (909) 427-5679
DR. JING YA GAO DO
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD
FONTANA, CA 92335
San Bernardino County (833) 574-2273
EMILY ISABEL MULDER
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
San Bernardino County (833) 574-2273

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Matthew Bergendahl's NPI number?

The NPI number for Matthew Bergendahl is 1417650268. It was assigned to this individual provider in the NPPES registry on March 22, 2023.

Where is Matthew Bergendahl located?

Matthew Bergendahl practices at 17234 Valley Blvd Building A, Fontana, CA 92335. The listed phone number is (657) 248-9435.

What is Matthew Bergendahl's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Matthew Bergendahl enrolled in Medicare?

Yes. Matthew Bergendahl is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Matthew Bergendahl was last updated on September 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.