Individual provider Active NPI

Ronald Farris I, RADT 1

  • Addiction (Substance Use Disorder) Counselor
  • Los Angeles, CA
National Provider Identifier
1558807685
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
155 Bimini PL
Los Angeles, CA 90004-5902
Phone
(213) 388-5423
Fax
(213) 388-1317
NPI assigned
Jan 12, 2017
Last updated
Jan 12, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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 NU Primary

Addresses

Primary practice location

155 Bimini PL
Los Angeles, CA 90004-5902

Mailing address

1503 W 112TH St
Los Angeles, CA 90047-4928
Phone (323) 836-2001

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": "1484179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1558807685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 W 112TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900474928",
            "telephone_number": "323-836-2001",
            "fax_number": "213-388-1317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 BIMINI PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900045902",
            "telephone_number": "213-388-5423",
            "fax_number": "213-388-1317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRIS",
        "first_name": "RONALD",
        "name_suffix": "I",
        "credential": "RADT 1",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-12",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; 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.