Individual provider Active NPI

Luiz Enrique Gomez Benavides

  • Peer Specialist
  • Riverside, CA
National Provider Identifier
1487454336
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
3333 14TH St
Riverside, CA 92501-3858
Phone
(951) 203-0819
NPI assigned
Mar 18, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X CA Primary

Addresses

Primary practice location

3333 14TH St
Riverside, CA 92501-3858

Mailing address

3909 Terracina Dr
Riverside, CA 92506-0150
Phone (951) 203-0819

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

NPI Registry JSON

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

{
    "created_epoch": "1742256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1487454336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 TERRACINA DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925060150",
            "telephone_number": "951-203-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 14TH ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013858",
            "telephone_number": "951-203-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ BENAVIDES",
        "first_name": "LUIZ",
        "middle_name": "ENRIQUE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "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 Nov 3, 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.