Individual provider Active NPI

Victor Tarros

  • Addiction (Substance Use Disorder) Counselor
  • Upland, CA
National Provider Identifier
1417778606
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
R1597490125 Issued in CA
Practice address
239 W 9TH St
Upland, CA 91786-5979
Phone
(909) 981-6121
NPI assigned
Oct 21, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R1597490125 CA Primary

Addresses

Primary practice location

239 W 9TH St
Upland, CA 91786-5979

Mailing address

993 S Date Ave
Rialto, CA 92376-7626
Phone (909) 561-1065

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

State licenses

LicenseStateTypeSpecialty
R1597490125CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
His House New Creation Treatment Center Addiction (Substance Use Disorder) CurrentSince Mar 20, 2025 Accepting new patients
G & C Swan Inc CurrentSince Mar 20, 2025 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1417778606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "993 S DATE AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923767626",
            "telephone_number": "909-561-1065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 W 9TH ST",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865979",
            "telephone_number": "909-981-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARROS",
        "first_name": "VICTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-21",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1597490125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; 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.