Active NPI
Luis Guillermo Banuelos Sr.
- Peer Specialist
- Indio, CA
National Provider Identifier
1326690835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 44199 Monroe St
Indio, CA 92201-3096 - Phone
- (760) 770-2286
- NPI assigned
- Jul 15, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
44199 Monroe St
Indio, CA 92201-3096
Mailing address
44199 Monroe St
Indio, CA 92201-3096
Phone (760) 770-2286
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": "1563148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651017600000",
"number": "1326690835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44199 MONROE ST",
"city": "INDIO",
"state": "CA",
"postal_code": "922013096",
"telephone_number": "760-770-2286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44199 MONROE ST",
"city": "INDIO",
"state": "CA",
"postal_code": "922013096",
"telephone_number": "760-770-2286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANUELOS",
"first_name": "LUIS",
"middle_name": "GUILLERMO",
"name_suffix": "Sr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-15",
"last_updated": "2022-04-27",
"certification_date": "2022-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indio, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.