Myrra Marie Stockman, CATCI

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

112518 Issued in CA

Practice address

4750 Palm Ave
Riverside, CA 92501-4012

Phone

(951) 686-0021

Fax

(951) 686-0026

NPI assigned

Jun 23, 2016

Last updated

Jan 19, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Myrra Marie Alo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• House of Hope Foundation Inc

  • Substance Abuse Rehabilitation Facility
  • San Pedro, CA
  • NPI 1043829971
  NPD (past)
• Whiteside Manor, Palm Facility

  • Substance Abuse Rehabilitation Facility
  • Riverside, CA
  • NPI 1467902502
  NPD (past)

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1255782983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 PALM AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014012",
            "telephone_number": "951-686-0021",
            "fax_number": "951-686-0026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 PALM AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014012",
            "telephone_number": "951-686-0021",
            "fax_number": "951-686-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKMAN",
        "first_name": "MYRRA",
        "middle_name": "MARIE",
        "credential": "CATCI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "112518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYRRA",
            "last_name": "ALO",
            "middle_name": "MARIE",
            "credential": "CATCI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Catherine Marical Stinnett, MD
• Carollyn Stockbarger
• Deja Maree Jane Stockdale
• Robert C Stockdale, DDS MS
• Charles Halloway Stockman
• Todd P Stockwell, AMFT161643
• Lisa Stokes
• Nicol Alejandra Stolar-Peterson, LCSW
• Gabriel Brian Stolin, DO
• Hope R Stoltie

• Addiction (Substance Use Disorder) Counselor in Riverside, CA
• Providers in Riverside, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; 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.