Legacy Valley Addiction Treatment

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

LEGACY VALLEY ADDICTION TREATMENT

Practice address

16519 Victor St Ste 302
Victorville, CA 92395-3967

Phone

(760) 305-9677

NPI assigned

Mar 5, 2025

Organization subpart

No

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

Authorized official

Name

Angela L Abbott, LMFTNPI 1336448059

Title

Chief Executive Officer

Phone

(760) 912-5553

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Angela Lynn Abbott, LMFT

  • Marriage & Family Therapist
  • Riverside, CA
  • NPI 1336448059

  Multi-Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1741132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741132800000",
    "number": "1366240301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12654 SEVENTH AVE",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923959577",
            "telephone_number": "760-912-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16519 VICTOR ST STE 302",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953967",
            "telephone_number": "760-305-9677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY VALLEY ADDICTION TREATMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-05",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A",
        "authorized_official_last_name": "ABBOTT",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "760-912-5553",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ouida She' Lee
• Paul Lee, MD
• Sameisha Dishanei Lee
• Thomas Kan Lee, OD
• Yonghee Lee, DDS
• Maricela Leiker
• Randy Leiker
• Cheryl Jean Lemley, MFT, INTERN
• Jill Lemus, LVN
• Katherine Lemus

• Mental Health Clinic/Center (Including Community Mental Health Center) in Victorville, CA
• Providers in Victorville, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.