Active NPI
Ryan Andrew Cleary
- Addiction (Substance Use Disorder) Counselor
- Colton, CA
National Provider Identifier
1447007182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 17556
- Practice address
- 23950 Prado LN
Colton, CA 92324-9734 - Phone
- (760) 219-5634
- NPI assigned
- May 1, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 17556 | CA | Primary |
Addresses
Primary practice location
23950 Prado LN
Colton, CA 92324-9734
Mailing address
4661 Arlington Ave Apt 3
Riverside, CA 92504-2739
Phone (760) 219-5634
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17556 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729728000000",
"number": "1447007182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4661 ARLINGTON AVE APT 3",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925042739",
"telephone_number": "760-219-5634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23950 PRADO LN",
"city": "COLTON",
"state": "CA",
"postal_code": "923249734",
"telephone_number": "760-219-5634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEARY",
"first_name": "RYAN",
"middle_name": "ANDREW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-01",
"last_updated": "2024-10-24",
"certification_date": "2024-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "17556",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.