Juan Reyes Acedo Jr., COUNSELOR

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1330 N Indian Canyon Dr
Palm Springs, CA 92262-4880

Phone

(760) 601-5062

NPI assigned

May 10, 2023

Last updated

Jun 23, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• WCHS, Inc

  dba Bellingham Treatment Solutions

  • Methadone Clinic
  • Bellingham, WA
  • NPI 1811592116
  NPD (past)

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1427748706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 N INDIAN CANYON DR",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624880",
            "telephone_number": "760-322-9065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 N INDIAN CANYON DR",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624880",
            "telephone_number": "760-601-5062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACEDO",
        "first_name": "JUAN",
        "middle_name": "REYES",
        "name_suffix": "Jr.",
        "credential": "COUNSELOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "AII5341214",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdallah Nazmi Abu-Samrah, M.D
• Ahmad Abuaisheh, MD
• Hilal Abuzahra, M.D.
• Access Medical, Inc.
• Alexis Accuar
• Lisset Acoeda
• Jayrom Lalicon Acorda, PHARM.D.
• Crystal Christine Acosta
• Belma Q Adamos, RPH
• James Melvin Adams, M.D.

• Addiction (Substance Use Disorder) Counselor in Palm Springs, CA
• Providers in Palm 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 Jun 23, 2023; 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.