Brenda Avila, PEER SUPPORT SPECIAL

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

1370 S State St Ste a
San Jacinto, CA 92583-4922

Phone

(951) 791-3350

NPI assigned

Aug 21, 2017

Last updated

Mar 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of Riverside

  dba San Jacinto SAPT

  • Community/Behavioral Health Agency
  • San Jacinto, CA
  • NPI 1194891283
  NPD (past)

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

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1366968349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 S STATE ST STE A",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925834922",
            "telephone_number": "951-761-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 S STATE ST STE A",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925834922",
            "telephone_number": "951-791-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA",
        "first_name": "BRENDA",
        "credential": "PEER SUPPORT SPECIAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-21",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyana Arrington-Harris
• Paulo C Arroyo
• Jessie Francisco Artagame
• Nagasamudra Shamarao Ashok, M.D.
• Bridget Austin, C.A.S.
• B II Aj Our House, LLC
• Tami Bailey
• Giovanna Balboa
• Theresa Baldwin, DDS, MA, MS
• Vidyamohan Balu

• Peer Specialist in San Jacinto, CA
• Providers in San Jacinto, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.