Individual provider Active NPI

Joel Porter, CADC

  • Addiction (Substance Use Disorder) Counselor
  • Fremont, CA
National Provider Identifier
1174804306
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
C053330518 Issued in CA
Practice address
37437 Glenmoor Dr
Fremont, CA 94536-5731
Phone
(510) 713-3200
Fax
(510) 713-0684
NPI assigned
Sep 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X C053330518 CA Primary

Addresses

Primary practice location

37437 Glenmoor Dr
Fremont, CA 94536-5731

Mailing address

4510 Peralta Blvd
Suite 1
Fremont, CA 94536-5755
Phone (510) 713-3202

Other practice location 1

531 24th St
Oakland, CA 94612-1721
Phone (510) 839-2525

Other identifiers 1

IdentifierTypeStateIssuer
C053330518OtherCACCAPP

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
C053330518CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Carneles Unidos Reformando Adictos Inc. 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1174804306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 PERALTA BLVD",
            "address_2": "SUITE 1",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945365755",
            "telephone_number": "510-713-3202",
            "fax_number": "510-713-0684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37437 GLENMOOR DR",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945365731",
            "telephone_number": "510-713-3200",
            "fax_number": "510-713-0684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "531 24th St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946121721",
            "country_code": "US",
            "telephone_number": "510-839-2525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTER",
        "first_name": "JOEL",
        "name_prefix": "Mr.",
        "credential": "CADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-01",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "C053330518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCAPP",
            "identifier": "C053330518",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.