Individual provider Active NPI

Geraldine Audrey Delafosse, CADC I

  • Addiction (Substance Use Disorder) Counselor
  • Laguna Hills, CA
National Provider Identifier
1003418203
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CI36400922 Issued in CA
Practice address
24953 Paseo de Valencia BLDG B Ste 1B
Laguna Hills, CA 92653-4340
Phone
(949) 540-0170
Fax
(949) 540-0173
NPI assigned
Nov 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CI36400922 CA Primary

Addresses

Primary practice location

24953 Paseo de Valencia BLDG B Ste 1B
Laguna Hills, CA 92653-4340

Mailing address

24953 Paseo de Valencia BLDG B Ste 1B
Laguna Hills, CA 92653-4340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CI36400922CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1605139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1003418203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24953 PASEO DE VALENCIA BLDG B STE 1B",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926534340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24953 PASEO DE VALENCIA BLDG B STE 1B",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926534340",
            "telephone_number": "949-540-0170",
            "fax_number": "949-540-0173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELAFOSSE",
        "first_name": "GERALDINE",
        "middle_name": "AUDREY",
        "name_prefix": "Ms.",
        "credential": "CADC I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-12",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "CI36400922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.