Active NPI
Angelique Danielle Laprise, SUDRC #12534
- Addiction (Substance Use Disorder) Counselor
- Diamond Springs, CA
National Provider Identifier
1063179810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 12534
- Practice address
- 484 Pleasant Valley Rd.
# 4
Diamond Springs, CA 95619 - Phone
- (530) 344-7633
- Fax
- (530) 497-5202
- NPI assigned
- Nov 29, 2021
- 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 | 12534 | CA | Primary |
Addresses
Primary practice location
484 Pleasant Valley Rd.
# 4
Diamond Springs, CA 95619
Mailing address
484 Pleasant Valley Rd.
# 4
Diamond Springs, CA 95619
Phone (530) 344-7633
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 |
|---|---|---|---|
| 12534 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638144000000",
"number": "1063179810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "484 PLEASANT VALLEY RD.",
"address_2": "# 4",
"city": "DIAMOND SPRINGS",
"state": "CA",
"postal_code": "95619",
"telephone_number": "530-344-7633",
"fax_number": "530-497-5202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "484 PLEASANT VALLEY RD.",
"address_2": "# 4",
"city": "DIAMOND SPRINGS",
"state": "CA",
"postal_code": "95619",
"telephone_number": "530-344-7633",
"fax_number": "530-497-5202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAPRISE",
"first_name": "ANGELIQUE",
"middle_name": "DANIELLE",
"credential": "SUDRC #12534",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-29",
"last_updated": "2021-11-29",
"certification_date": "2021-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "12534",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Diamond Springs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.