Individual provider Active NPI

Angel Santana Cabanillas Deleon, SUDRC

  • Addiction (Substance Use Disorder) Counselor
  • San Diego, CA
National Provider Identifier
1043018351
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
20791 Issued in CA
Practice address
1733 Euclid Ave
San Diego, CA 92105-5414
Phone
(619) 263-0433
Fax
(619) 263-3992
NPI assigned
Mar 4, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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 20791 CA Primary

Addresses

Primary practice location

1733 Euclid Ave
San Diego, CA 92105-5414

Mailing address

229 16TH St Apt 407
San Diego, CA 92101-7662
Phone (619) 514-5605

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
20791CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1741046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1043018351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 16TH ST APT 407",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921017662",
            "telephone_number": "619-514-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1733 EUCLID AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921055414",
            "telephone_number": "619-263-0433",
            "fax_number": "619-263-3992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABANILLAS DELEON",
        "first_name": "ANGEL",
        "middle_name": "SANTANA",
        "credential": "SUDRC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-04",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "20791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.