Active NPI
Kimberly Cruze
- Addiction (Substance Use Disorder) Counselor
- Arcadia, CA
National Provider Identifier
1194079913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 800 S Santa Anita Ave
Human Resources/Christina Gamboa
Arcadia, CA 91006-3536 - Phone
- (909) 622-2273
- Fax
- (909) 622-6334
- NPI assigned
- Oct 31, 2012
- Sex
- Female
- 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 | Primary |
Addresses
Primary practice location
800 S Santa Anita Ave
Human Resources/Christina Gamboa
Arcadia, CA 91006-3536
Mailing address
800 S.Santa Anita Avenue
Human Resources/Christina Gamboa
Arcadia, CA 91006
Phone (626) 254-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194079913 | Medicaid | CA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387324800000",
"number": "1194079913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 S.SANTA ANITA AVENUE",
"address_2": "HUMAN RESOURCES/CHRISTINA GAMBOA",
"city": "ARCADIA",
"state": "CA",
"postal_code": "91006",
"telephone_number": "626-254-5000",
"fax_number": "626-294-1079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 S SANTA ANITA AVE",
"address_2": "HUMAN RESOURCES/CHRISTINA GAMBOA",
"city": "ARCADIA",
"state": "CA",
"postal_code": "910063536",
"telephone_number": "909-622-2273",
"fax_number": "909-622-6334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZE",
"first_name": "KIMBERLY",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-31",
"last_updated": "2013-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1194079913",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Arcadia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.