Luis Jesus Maldonado, AOD COUNSELOR

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

179970 Issued in CA

Practice address

909 Pico Blvd
Santa Monica, CA 90405-1326

Phone

(310) 314-6200

NPI assigned

Aug 7, 2018

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

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1609355155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 PICO BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904051326",
            "telephone_number": "310-314-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 PICO BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904051326",
            "telephone_number": "310-314-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "LUIS",
        "middle_name": "JESUS",
        "credential": "AOD  COUNSELOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "179970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meena Makhijani, D.O.
• Edith Malachi X
• Maldonado Medical, LLC
• Irma Maldonado-Enriquez, PSY.D.
• Amanda Katherine Maldonado, DDS
• Ali Ashgar Maleksaeedi, DPT
• Paul Maler, MD
• Arsalan Malik, MD
• Barnet David Malin, M.D.
• Colleen Marie Malinow, N.P.

• Addiction (Substance Use Disorder) Counselor in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.