Individual provider Active NPI

Damiso Saeed Vaughns, CERTIFICATION

  • Addiction (Substance Use Disorder) Counselor
  • Downey, CA
National Provider Identifier
1336650753
Registry record updated Oct 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
9755-R Issued in CA
Practice address
11500 Paramount Blvd
Downey, CA 90241-4530
Phone
(562) 923-4545
Fax
(562) 869-1835
NPI assigned
Oct 12, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2017

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 9755-R CA Primary

Addresses

Primary practice location

11500 Paramount Blvd
Downey, CA 90241-4530

Mailing address

347 W 78TH St
Los Angeles, CA 90003-2413
Phone (323) 535-2950

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

State licenses

LicenseStateTypeSpecialty
9755-RCAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Public Health Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: damisovaughns-scadpinc@lacsapc.netsmartdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507766400000",
    "number": "1336650753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 W 78TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900032413",
            "telephone_number": "323-535-2950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11500 PARAMOUNT BLVD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902414530",
            "telephone_number": "562-923-4545",
            "fax_number": "562-869-1835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHNS",
        "first_name": "DAMISO",
        "middle_name": "SAEED",
        "name_prefix": "Mr.",
        "credential": "CERTIFICATION",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-12",
        "last_updated": "2017-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "9755-R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2017; 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.