Randi R Utecht, AOD

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

RA9951120 Issued in CA

Practice address

2136 El Cajon Blvd
San Diego, CA 92104-1102

Phone

(619) 515-2588

Fax

(619) 450-6267

NPI assigned

Oct 13, 2020

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

• Randi R Ruble Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1285232199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2300",
            "fax_number": "619-237-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2136 EL CAJON BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921041102",
            "telephone_number": "619-515-2588",
            "fax_number": "619-450-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTECHT",
        "first_name": "RANDI",
        "middle_name": "R",
        "credential": "AOD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "RA9951120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDI",
            "last_name": "RUBLE",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amy Elizabeth Ustjanauskas, PH.D.
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• Alessandra Catherine Utz, LMFT
• Edward Russell Utz, M.D.

• Addiction (Substance Use Disorder) Counselor in San Diego, CA
• Providers in San Diego, 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 Nov 20, 2020; 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.