Active NPI
Rudolph Garcia
- Addiction (Substance Use Disorder) Counselor
- West Covina, CA
National Provider Identifier
1093530453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- R1554040324
- Practice address
- 2441 S Nadine St
West Covina, CA 91792-3562 - Phone
- (562) 714-2069
- NPI assigned
- Nov 20, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | R1554040324 | CA | Primary |
Addresses
Primary practice location
2441 S Nadine St
West Covina, CA 91792-3562
Mailing address
831 E Arrow Hwy
Pomona, CA 91767-2535
Phone (909) 398-4383
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 |
|---|---|---|---|
| R1554040324 | 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": "1732060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732060800000",
"number": "1093530453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "831 E ARROW HWY",
"city": "POMONA",
"state": "CA",
"postal_code": "917672535",
"telephone_number": "909-398-4383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2441 S NADINE ST",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917923562",
"telephone_number": "562-714-2069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA",
"first_name": "RUDOLPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-11-20",
"last_updated": "2024-11-20",
"certification_date": "2024-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R1554040324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.