Individual provider Active NPI

Richard Peter Embree

  • Addiction (Substance Use Disorder) Counselor
  • Fullerton, CA
National Provider Identifier
1629403795
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
C054040518 Issued in CA
Practice address
218 E Commonwealth Ave
Fullerton, CA 92832-1911
Phone
(714) 992-4770
Fax
(714) 992-5475
NPI assigned
Sep 9, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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 C054040518 CA Primary

Addresses

Primary practice location

218 E Commonwealth Ave
Fullerton, CA 92832-1911

Mailing address

5870 Arlington Ave Ste 103
Riverside, CA 92504-2037
Phone (951) 683-6596

Other practice location 1

100 E Market St
Long Beach, CA 90805-5924
Phone (562) 428-4222

Other practice location 2

17270 Roosevelt St
Riverside, CA 92508-9523
Phone (951) 780-2541

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

State licenses

LicenseStateTypeSpecialty
C054040518CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mfi Recovery Center PastSince Jul 23, 2023 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1378684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1629403795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5870 ARLINGTON AVE STE 103",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925042037",
            "telephone_number": "951-683-6596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 E COMMONWEALTH AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321911",
            "telephone_number": "714-992-4770",
            "fax_number": "714-992-5475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Market St",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908055924",
            "country_code": "US",
            "telephone_number": "562-428-4222",
            "fax_number": "562-428-0372",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17270 Roosevelt St",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925089523",
            "country_code": "US",
            "telephone_number": "951-780-2541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EMBREE",
        "first_name": "RICHARD",
        "middle_name": "PETER",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-09",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "C054040518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; 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.