Individual provider Active NPI

Jose Luis Aguilar Jr., M.D.

  • Psychiatry Physician
  • Colton, CA
National Provider Identifier
1619255783
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A122466 Issued in CA
Practice address
400 N Pepper Ave
Colton, CA 92324-1819
Phone
(909) 580-1000
NPI assigned
Jul 23, 2011
Last updated
Aug 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A122466 CA Primary
Addiction Medicine (Preventive Medicine) Physician 2083A0300X A122466 CA

Addresses

Primary practice location

400 N Pepper Ave
Colton, CA 92324-1819

Mailing address

12460 California St Unit 1224
Yucaipa, CA 92399-8757
Phone (760) 406-1061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130130000253 CA Practitioner - Psychiatry 7618121518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Psychiatry PCGroup PAC ID 0244522159, 93 clinicians

Practice addresses (Care Compare)

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A122466CAMDAddiction Medicine (Preventive Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Psychiatry PC Psychiatry CurrentSince Mar 1, 2020 Accepting new patients
Cep America - Psychiatry PC Psychiatry CurrentSince Mar 1, 2020 Accepting new patients
Cep America - Psychiatry PC Psychiatry Current Accepting new patients
Eisenhower Medical Center Past Accepting new patients

Locations

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1400

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

Interoperability endpoints

  • Direct secure messaging: jose.aguilar.1@10039.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1311379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1619255783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12460 CALIFORNIA ST UNIT 1224",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923998757",
            "telephone_number": "760-406-1061",
            "fax_number": "760-280-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241819",
            "telephone_number": "909-580-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILAR",
        "first_name": "JOSE",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-23",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A122466",
            "primary": true
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "CA",
            "license": "A122466",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.