Individual provider Active NPI

Cris Martinez Verdugo

  • Peer Specialist
  • Los Angeles, CA
National Provider Identifier
1053850883
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
MPSS-IZUEFK Issued in CA
Practice address
8836 S Vermont Ave
Los Angeles, CA 90044-4832
Phone
(323) 593-5300
NPI assigned
Feb 13, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X
Peer Specialist 175T00000X MPSS-IZUEFK CA Primary
Day Training/Habilitation Specialist 373H00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X CATC #174380I CA

Addresses

Primary practice location

8836 S Vermont Ave
Los Angeles, CA 90044-4832

Mailing address

8836 S Vermont Ave
Los Angeles, CA 90044-4832
Phone (323) 921-8803

Other practice location 1

8836 S Vermont Ave
Los Angeles, CA 90044-4832
Phone (323) 593-5300

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
CATC #174380ICAMDAddiction (Substance Use Disorder) Counselor
MPSS-IZUEFKCAMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1053850883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8836 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900444832",
            "telephone_number": "323-921-8803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8836 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900444832",
            "telephone_number": "323-593-5300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8836 S Vermont Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900444832",
            "country_code": "US",
            "telephone_number": "323-593-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ VERDUGO",
        "first_name": "CRIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-13",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-IZUEFK",
            "primary": true
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "CATC #174380I",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

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