Individual provider Active NPI

Nolan Perine

  • Addiction (Substance Use Disorder) Counselor
  • Bloomington, CA
National Provider Identifier
1306088935
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
C14141214 Issued in CA
Practice address
18612 Santa Ana Ave
Bloomington, CA 92316-2636
Phone
(909) 421-7120
Fax
(909) 421-7128
NPI assigned
Mar 27, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X C14141214 CA Primary

Addresses

Primary practice location

18612 Santa Ana Ave
Bloomington, CA 92316-2636

Mailing address

18612 Santa Ana Ave
Bloomington, CA 92316-2636
Phone (909) 421-7120

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

NPI Registry JSON

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

{
    "created_epoch": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1306088935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18612 SANTA ANA AVE",
            "city": "BLOOMINGTON",
            "state": "CA",
            "postal_code": "923162636",
            "telephone_number": "909-421-7120",
            "fax_number": "909-421-7128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18612 SANTA ANA AVE",
            "city": "BLOOMINGTON",
            "state": "CA",
            "postal_code": "923162636",
            "telephone_number": "909-421-7120",
            "fax_number": "909-421-7128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERINE",
        "first_name": "NOLAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-27",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "C14141214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; 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.