Lakewood Recovery LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

LAKEWOOD RECOVERY LLC

Practice address

8911 Lakewood Dr Ste 22a
Windsor, CA 95492-7858

Phone

(323) 510-1283

NPI assigned

Aug 19, 2026

Last updated

Aug 19, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amy Tello

Title

Manager

Phone

(323) 510-1283

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1787097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787097600000",
    "number": "1073429346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8911 LAKEWOOD DR STE 22A",
            "city": "WINDSOR",
            "state": "CA",
            "postal_code": "954927858",
            "telephone_number": "323-510-1283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8911 LAKEWOOD DR STE 22A",
            "city": "WINDSOR",
            "state": "CA",
            "postal_code": "954927858",
            "telephone_number": "323-510-1283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-19",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A",
        "authorized_official_last_name": "TELLO",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "323-510-1283"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie Kneibler, MD
• Emily Kong, PPS
• Ira Koren, D.D.S.
• Evan Y Kubota
• Joshua Shepard Kucker, MD
• Yesenia Ledezma Ruiz
• Valerie N Lester, RDHAP
• Gregory Levy, RPH
• Steven M Licea
• Jessica Lickey

• Substance Use Disorder Rehabilitation Clinic/Center in Windsor, CA
• Providers in Windsor, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.