Emerson Groom, RADT1

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1242690217 Issued in CA

Practice address

2101 E 1St St
Santa Ana, CA 92705-4007

Phone

(714) 581-9181

NPI assigned

Aug 16, 2017

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": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502841600000",
    "number": "1619493210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 S BRISTOL ST",
            "address_2": "8Q",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927046727",
            "telephone_number": "714-583-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 E 1ST ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054007",
            "telephone_number": "714-581-9181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROOM",
        "first_name": "EMERSON",
        "credential": "RADT1",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-16",
        "last_updated": "2017-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1242690217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lilian D Griffiths
• Grigory Rozenvich D.D.S., Inc.
• Frank Anthony Grimaldi, M.A.
• Heather Kristin Grimaldi, M.S, BCBA
• Maren Grimm, RPA
• Gerald Joseph Grosso, PSYD
• Anouk Verma Grover
• Cecilia M Grover, D.D.S.
• Maleah Grover, M.D.
• Sheridon Hale Groves

• Addiction (Substance Use Disorder) Counselor in Santa Ana, CA
• Providers in Santa Ana, 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 16, 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.