Individual provider Active NPI

Ruby Arellano, CADC LL- CA

  • Addiction (Substance Use Disorder) Counselor
  • Moreno Valley, CA
National Provider Identifier
1558692889
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
A1008301146 Issued in CA
Practice address
23119 Cottonwood Ave Ste 100
Moreno Valley, CA 92553-9661
Phone
(951) 413-5130
NPI assigned
Jan 27, 2010
Last updated
May 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X A1008301146 CA Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

23119 Cottonwood Ave Ste 100
Moreno Valley, CA 92553-9661

Mailing address

28321 Championship Dr
Moreno Valley, CA 92555-6303
Phone (951) 567-4405

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

LicenseStateTypeSpecialty
A1008301146CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1264550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1558692889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28321 CHAMPIONSHIP DR",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925556303",
            "telephone_number": "951-567-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23119 COTTONWOOD AVE STE 100",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925539661",
            "telephone_number": "951-413-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARELLANO",
        "first_name": "RUBY",
        "name_prefix": "Ms.",
        "credential": "CADC LL- CA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-27",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A1008301146",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.

Verify at the official NPI Registry.