Individual provider Active NPI

Tyler Robert Arp

  • Addiction (Substance Use Disorder) Counselor
  • Upland, CA
National Provider Identifier
1114643954
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
A053211122 Issued in CA
Practice address
1260 E Arrow Hwy BLDG E
Upland, CA 91786-4984
Phone
(909) 932-1069
NPI assigned
Oct 13, 2022
Last updated
Jun 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X A053211122 CA Primary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X CI33860821 CA

Addresses

Primary practice location

1260 E Arrow Hwy BLDG E
Upland, CA 91786-4984

Mailing address

1260 E Arrow Hwy BLDG E
Upland, CA 91786-4984
Phone (909) 932-1069

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL RTC Health Information Exchange (HIE) MFI Recovery Center

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

LicenseStateTypeSpecialty
A053211122CAMDAddiction (Substance Use Disorder) Counselor
CI33860821CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Valley Drug and Alcohol Recovery Services CurrentSince Jun 9, 2024 Accepting new patients
Inland Valley Drug and Alcohol Recovery Services CurrentSince Jun 9, 2024 Accepting new patients

Locations

1260 E Arrow Hwy
Bldg E
Upland, CA 91786
Phone (909) 608-2002

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1665619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1114643954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 E ARROW HWY BLDG E",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864984",
            "telephone_number": "909-932-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 E ARROW HWY BLDG E",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864984",
            "telephone_number": "909-932-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARP",
        "first_name": "TYLER",
        "middle_name": "ROBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-13",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A053211122",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "CI33860821",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "RTC",
            "affiliation": "Y",
            "endpointDescription": "RTC",
            "affiliationName": "MFI Recovery Center",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5870 Arlington Ave",
            "address_2": "103",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "92504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.

Verify at the official NPI Registry.