Priscilla Monique Portillo

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

SUDRC12521 Issued in CA

Practice address

12070 Telegraph Rd
Santa Fe Springs, CA 90670-3771

Phone

(562) 777-7500

NPI assigned

Mar 8, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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 and National Provider Directory roles.

• Newport Mental Health Center LLC

  • Adult Mental Health Clinic/Center
  • Newport Beach, CA
  • NPI 1992525240
  NPD Authorized official
• Southwest Addiction Centers LLC

  • Community/Behavioral Health Agency
  • Albuquerque, NM
  • NPI 1982547972
  NPD Authorized official

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

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1346940301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12070 TELEGRAPH RD",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703771",
            "telephone_number": "562-777-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12070 TELEGRAPH RD",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703771",
            "telephone_number": "562-777-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTILLO",
        "first_name": "PRISCILLA",
        "middle_name": "MONIQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-08",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "SUDRC12521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Deana Porter
• Stephanie Porter
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• Garry Powers
• Jordy Poz Poz
• Genesis Preciado
• Maria Haydee Preza

• Addiction (Substance Use Disorder) Counselor in Santa Fe Springs, CA
• Providers in Santa Fe Springs, 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 Mar 8, 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.