Active NPI
Ruben Pena
- Student in an Organized Health Care Education/Training Program
- Gardena, CA
National Provider Identifier
1073873584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 108 W Victoria St
Gardena, CA 90248-3523 - Phone
- (310) 759-6866
- NPI assigned
- May 18, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | CA | Primary | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X |
Addresses
Primary practice location
108 W Victoria St
Gardena, CA 90248-3523
Mailing address
506 W Jackman St
Lancaster, CA 93534-2531
Phone (661) 726-2850
Other practice location 1
43845 10th St W Ste 2B
Lancaster, CA 93534-4800
Phone (661) 940-9094
Other practice location 2
506 W Jackman St
Lancaster, CA 93534-2531
Phone (661) 726-2850
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780963200000",
"number": "1073873584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "506 W JACKMAN ST",
"city": "LANCASTER",
"state": "CA",
"postal_code": "935342531",
"telephone_number": "661-726-2850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 W VICTORIA ST",
"city": "GARDENA",
"state": "CA",
"postal_code": "902483523",
"telephone_number": "310-759-6866"
}
],
"practiceLocations": [
{
"address_1": "43845 10th St W Ste 2B",
"address_purpose": "LOCATION",
"city": "Lancaster",
"state": "CA",
"postal_code": "935344800",
"country_code": "US",
"telephone_number": "661-940-9094",
"fax_number": "661-265-1101",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "506 W Jackman St",
"address_purpose": "LOCATION",
"city": "Lancaster",
"state": "CA",
"postal_code": "935342531",
"country_code": "US",
"telephone_number": "661-726-2850",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PENA",
"first_name": "RUBEN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-18",
"last_updated": "2026-06-09",
"certification_date": "2026-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": null,
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.