Active NPI
Luis Enrique Bravo-Avina
- Counselor
- Santa Rosa, CA
National Provider Identifier
1629402227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1200 College Ave
Santa Rosa, CA 95404-3908 - Phone
- (707) 568-2300
- NPI assigned
- Aug 30, 2013
- Last updated
- Aug 30, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
1200 College Ave
Santa Rosa, CA 95404-3908
Mailing address
1200 College Ave
Santa Rosa, CA 95404-3908
Phone (707) 568-2300
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": "1377820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377820800000",
"number": "1629402227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 COLLEGE AVE",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954043908",
"telephone_number": "707-568-2300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 COLLEGE AVE",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954043908",
"telephone_number": "707-568-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAVO-AVINA",
"first_name": "LUIS",
"middle_name": "ENRIQUE",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-30",
"last_updated": "2013-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.