Kambiz Izadseta

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

A019230615 Issued in CA

Practice address

7885 Annandale Ave
Desert Hot Springs, CA 92240-1419

Phone

(760) 329-2925

Fax

(760) 329-0169

NPI assigned

Oct 30, 2015

Sex

Male

Sole proprietor

No

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.

• The Ranch Recovery Centers Inc

  • Substance Abuse Rehabilitation Facility
  • Desert Hot Springs, CA
  • NPI 1649333030
  NPD (past)

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1386016202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7885 ANNANDALE AVE",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922401419",
            "telephone_number": "760-329-2925",
            "fax_number": "760-329-0169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7885 ANNANDALE AVE",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922401419",
            "telephone_number": "760-329-2925",
            "fax_number": "760-329-0169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZADSETA",
        "first_name": "KAMBIZ",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-30",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A019230615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Husband
• Baoanh Huynh, RPH
• Christine Huynh
• Intrepid Interpreters
• Dylan Marie Izadseta, A.A, CADC II
• Melissa Eileen Jackson, LPT
• Jae Won Lee DDS, Inc
• Edith Jaimes
• Bruce David Janzen
• Cassandra Patricia Jenikovsky

• Addiction (Substance Use Disorder) Counselor in Desert Hot Springs, CA
• Providers in Desert Hot 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 Oct 30, 2015; 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.