Christian James Beaver, ACCBC AND CAADE
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Holtville, CA
NPI 1376167759 · NPPES record last updated Jun 2, 2020
Key facts
- NPI
- 1376167759
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- A7939434 (CA)
- Practice address
- 2149 Orchard Rd
Holtville, CA 92250 - Phone
- (442) 231-6760
- NPI assigned
- Jun 2, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A7939434 | CA | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | A7939434 | CA | Yes |
Addresses
Primary practice location
2149 Orchard Rd
Holtville, CA 92250
Mailing address
2149 Orchard Rd
Holtville, CA 92250
Phone (442) 231-6760
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 91562514C19066 | Other | CA | STATE OF CALIFORNIA BENEFITS IDENTIFICATION CARD |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Holtville | Health Information Exchange (HIE) |
Other providers in Holtville, CA
- Gabia Alejandra Ambrocio
- Jazlyn Bedolla
- Ana Karen Cano
- Abril Castaneda
- Gayle A. Cheatwood
- Vianey Durazo
All providers in Holtville, CA · Addiction (Substance Use Disorder) Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.