Active NPI
Stephen Peevy, RAS
- Addiction (Substance Use Disorder) Counselor
- Pomona, CA
National Provider Identifier
1114237161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- P1108261657
- Practice address
- 160 E Holt Ave
B
Pomona, CA 91767-5406 - Phone
- (909) 620-2521
- Fax
- (909) 620-9793
- NPI assigned
- Oct 8, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 | P1108261657 | CA | Primary |
Addresses
Primary practice location
160 E Holt Ave
B
Pomona, CA 91767-5406
Mailing address
113 S Fircroft St
West Covina, CA 91791-2004
Phone (626) 339-4590
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 |
|---|---|---|---|
| P1108261657 | 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": "1286496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401235200000",
"number": "1114237161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 S FIRCROFT ST",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917912004",
"telephone_number": "626-339-4590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 E HOLT AVE",
"address_2": "B",
"city": "POMONA",
"state": "CA",
"postal_code": "917675406",
"telephone_number": "909-620-2521",
"fax_number": "909-620-9793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEEVY",
"first_name": "STEPHEN",
"credential": "RAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-10-08",
"last_updated": "2014-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "P1108261657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.