Active NPI
Adrian Reyes
- Clinical Social Worker
- Riverside, CA
National Provider Identifier
1396405247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 525 Technology CT Ste 105
Riverside, CA 92507-2181 - Phone
- (951) 686-8500
- NPI assigned
- Dec 20, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
525 Technology CT Ste 105
Riverside, CA 92507-2181
Mailing address
81404 Avenida Gonzales
Indio, CA 92201-8467
Phone (760) 698-3817
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Olive Crest | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Riverside, CA
- NPI 1215418165
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718841600000",
"number": "1396405247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "81404 AVENIDA GONZALES",
"city": "INDIO",
"state": "CA",
"postal_code": "922018467",
"telephone_number": "760-698-3817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 TECHNOLOGY CT STE 105",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925072181",
"telephone_number": "951-686-8500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "ADRIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-12-20",
"last_updated": "2024-06-20",
"certification_date": "2024-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.