Larry Richard Ozaeta II

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

MPSS-LESYGV Issued in CA

Practice address

43250 Midnight CT
Banning, CA 92220-9565

Phone

(951) 922-1725

NPI assigned

Mar 12, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Mfi Recovery Center

  • Substance Abuse Rehabilitation Facility
  • Banning, CA
  • NPI 1164194080
  NPD

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

{
    "created_epoch": "1741737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1548069354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5870 ARLINGTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925042037",
            "telephone_number": "951-683-6596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43250 MIDNIGHT CT",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922209565",
            "telephone_number": "951-922-1725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OZAETA",
        "first_name": "LARRY",
        "middle_name": "RICHARD",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-12",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-LESYGV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ha Quyen Thi Ong, PHARM.D
• Alma Rosa Ontiveros
• Stephanie Marie Ooley
• Gladys Orellana
• Katie Selena Ortega Gonzalez
• Pain Management Partners, LP
• Amy Michelle Paladino, AOD
• Marcos Palafox, M.D
• Joshua Pannell
• Clare Park, PHARMD

• Peer Specialist in Banning, CA
• Providers in Banning, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.