Antoni A Miranda, CHW

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

31739 Riverside Dr Ste A1
Lake Elsinore, CA 92530-7818

Phone

(951) 245-0505

Fax

(951) 245-0999

NPI assigned

Mar 7, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1709769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1013775766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31739 RIVERSIDE DR",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925307818",
            "telephone_number": "951-245-0506",
            "fax_number": "951-245-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31739 RIVERSIDE DR STE A1",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925307818",
            "telephone_number": "951-245-0505",
            "fax_number": "951-245-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "ANTONI",
        "middle_name": "A",
        "credential": "CHW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-07",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Michelle Miller, FNP
• Jared Miller, RADT
• Julia Mae Miller, PPS
• Shane Conley Mills
• Lori A Minor-Honore, MFTI
• Crystal Brianne Miranda
• Dominique Renee Misher
• Mobility Repair Specialists Inc
• Rachel Nicole Mobley
• Teresa Mojarro Ortega, MSW, ACSW

• Community Health Worker in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.