Desiray Buntain

Key facts

NPI

1225201593

Entity type

Individual (NPI type 1)

Primary specialty

Addiction (Substance Use Disorder) Counselor 101YA0400X

Practice address

5200 San Gabriel PL
Pico Rivera, CA 90660-2497

Phone

(562) 222-1331

NPI assigned

Apr 8, 2008

Sex

Female

Sole proprietor

Yes

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.

• Los Angeles County Department of Public Health Public Health or Welfare Agency · Alhambra, CA · NPI 1700090834
  NPD

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Practice roles

Interoperability endpoints

• Direct secure messaging: desiraybuntain-americanhealthservices@lacsapc.netsmartdirect.net

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 8, 2008.

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1225201593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 SAN GABRIEL PL",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906602497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 SAN GABRIEL PL",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906602497",
            "telephone_number": "562-222-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNTAIN",
        "first_name": "DESIRAY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Pico Rivera, CA · Addiction (Substance Use Disorder) Counselor in California