Active NPI
Gina Reigh Fraga, RADT
- Addiction (Substance Use Disorder) Counselor
- Trabuco Canyon, CA
National Provider Identifier
1043041015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- R1566820724
- Practice address
- 20331 Flanagan Road
Trabuco Canyon, CA 92679 - Phone
- (818) 582-8832
- Fax
- (818) 582-8836
- NPI assigned
- Aug 12, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | R1566820724 | CA | Primary |
Addresses
Primary practice location
20331 Flanagan Road
Trabuco Canyon, CA 92679
Mailing address
23531 Avenida la Caza Unit 117
Coto de Caza, CA 92679-3953
Phone (949) 400-5376
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
| License | State | Type | Specialty |
|---|---|---|---|
| R1566820724 | CA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Teen Project, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Children's Substance Abuse Rehabilitation Facility
- Trabuco Canyon, CA
- NPI 1609345743
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723420800000",
"number": "1043041015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23531 AVENIDA LA CAZA UNIT 117",
"city": "COTO DE CAZA",
"state": "CA",
"postal_code": "926793953",
"telephone_number": "949-400-5376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20331 FLANAGAN ROAD",
"city": "TRABUCO CANYON",
"state": "CA",
"postal_code": "92679",
"telephone_number": "818-582-8832",
"fax_number": "818-582-8836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRAGA",
"first_name": "GINA",
"middle_name": "REIGH",
"name_prefix": "Ms.",
"credential": "RADT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-12",
"last_updated": "2024-08-12",
"certification_date": "2024-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R1566820724",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Trabuco Canyon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.