Individual provider Active NPI

Rosemary Carreno

  • Peer Specialist
  • Colton, CA
National Provider Identifier
1205650256
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
MPSS-EJSOKG Issued in CA
Practice address
23950 Prado LN
Colton, CA 92324-9734
Phone
(909) 514-1958
NPI assigned
Nov 14, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X MPSS-EJSOKG CA Primary

Addresses

Primary practice location

23950 Prado LN
Colton, CA 92324-9734

Mailing address

23950 Prado LN
Colton, CA 92324-9734

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
MPSS-EJSOKGCAMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
G & C Swan Inc CurrentSince Jan 26, 2025 Accepting new patients
G & C Swan Inc PastSince Nov 17, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1731542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1205650256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23950 PRADO LN",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923249734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23950 PRADO LN",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923249734",
            "telephone_number": "909-514-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRENO",
        "first_name": "ROSEMARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-14",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-EJSOKG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

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