Individual provider Active NPI

Brian Santos

  • Addiction (Substance Use Disorder) Counselor
  • Pomona, CA
National Provider Identifier
1497099261
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
4 Village Loop
Pomona, CA 91766
Phone
(909) 865-0191
NPI assigned
Nov 19, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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 Primary

Addresses

Primary practice location

4 Village Loop
Pomona, CA 91766

Mailing address

4 Village Loop Rd
Pomona, CA 91766-4891
Phone (909) 865-0191

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Care and Health Services Past Accepting new patients

Organizations & group practices 1

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": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353283200000",
    "number": "1497099261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 VILLAGE LOOP RD",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917664891",
            "telephone_number": "909-865-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 VILLAGE LOOP",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "91766",
            "telephone_number": "909-865-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "BRIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; 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.