Active NPI
Ravindra Peiris
- Rehabilitation Practitioner
- Bakersfield, CA
National Provider Identifier
1164875803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 4200 Crescent Rock LN
Bakersfield, CA 93311-2860 - Phone
- (661) 491-3402
- NPI assigned
- Jul 18, 2016
- Last updated
- Jan 21, 2026
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | CA | Primary | |
| Case Manager/Care Coordinator | 171M00000X |
Addresses
Primary practice location
4200 Crescent Rock LN
Bakersfield, CA 93311-2860
Mailing address
4200 Crescent Rock LN
Bakersfield, CA 93311-2860
Phone (661) 492-3402
Other practice location 1
3012 Pecangrove Dr
Bakersfield, CA 93311-2331
Phone (661) 564-8028
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willie Young's Home for Young Men | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Walt's Home for Young Men
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Bakersfield, CA
- NPI 1548859556
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768953600000",
"number": "1164875803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4200 CRESCENT ROCK LN",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933112860",
"telephone_number": "661-492-3402",
"fax_number": "661-491-3400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4200 CRESCENT ROCK LN",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933112860",
"telephone_number": "661-491-3402"
}
],
"practiceLocations": [
{
"address_1": "3012 Pecangrove Dr",
"address_purpose": "LOCATION",
"city": "Bakersfield",
"state": "CA",
"postal_code": "933112331",
"country_code": "US",
"telephone_number": "661-564-8028",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PEIRIS",
"first_name": "RAVINDRA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-18",
"last_updated": "2026-01-21",
"certification_date": "2026-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "CA",
"license": null,
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.