Gloria Rose Campbell, CAADE

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

061301 Issued in CA

Practice address

1076 Santo Antonio Dr
Ste B
Colton, CA 92324-8103

Phone

(909) 433-9824

Fax

(909) 433-9830

NPI assigned

Mar 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Gloria Rose Jimenez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467586941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 E 12TH ST",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922231916",
            "telephone_number": "951-769-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 SANTO ANTONIO DR",
            "address_2": "STE B",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923248103",
            "telephone_number": "909-433-9824",
            "fax_number": "909-433-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "GLORIA",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "CAADE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "061301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLORIA",
            "last_name": "JIMENEZ",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Brady Campbell
• Sonia Angelica Campos Oliveira, MS, APCC
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• Kristy Thanh Cao, PHARM.D

• Addiction (Substance Use Disorder) Counselor in Colton, CA
• Providers in Colton, 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 Jul 8, 2007; 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.