Active NPI
Luis A Moncada-Reyes Sr.
- Addiction (Substance Use Disorder) Counselor
- San Bruno, CA
National Provider Identifier
1245782275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 1001 Sneath LN Ste 210
San Bruno, CA 94066 - Phone
- (650) 244-1441
- Fax
- (650) 244-1447
- NPI assigned
- Oct 25, 2016
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
1001 Sneath LN Ste 210
San Bruno, CA 94066
Mailing address
1001 Sneath LN Ste 210
San Bruno, CA 94066-2349
Phone (650) 244-1441
Other practice location 1
368 Fell St
San Francisco, CA 94102-5144
Phone (415) 861-0828 ext. 132
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 |
|---|---|---|---|
| Latino Commission on Alcohol and Drug Abuse Services of San Mateo Coun | Addiction (Substance Use Disorder) | 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.
-
- Substance Abuse Rehabilitation Facility
- San Bruno, CA
- NPI 1417093105
Addiction (Substance Use Disorder)
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619481600000",
"number": "1245782275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 SNEATH LN STE 210",
"city": "SAN BRUNO",
"state": "CA",
"postal_code": "940662349",
"telephone_number": "650-244-1441",
"fax_number": "650-244-1447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 SNEATH LN STE 210",
"city": "SAN BRUNO",
"state": "CA",
"postal_code": "94066",
"telephone_number": "650-244-1441",
"fax_number": "650-244-1447"
}
],
"practiceLocations": [
{
"address_1": "368 Fell St",
"address_purpose": "LOCATION",
"city": "San Francisco",
"state": "CA",
"postal_code": "941025144",
"country_code": "US",
"telephone_number": "415-861-0828 x132",
"fax_number": "415-861-0140",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MONCADA-REYES",
"first_name": "LUIS",
"middle_name": "A",
"name_suffix": "Sr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-25",
"last_updated": "2021-04-27",
"certification_date": "2021-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bruno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.