Individual provider Active NPI

Phillip B Ybarra, LPCC, LAADC

  • Mental Health Counselor
  • Temecula, CA
National Provider Identifier
1639460181
Registry record updated Aug 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPCC12138 Issued in CA
Practice address
32605 Temecula Pkwy
Suite 303
Temecula, CA 92592-6837
Phone
(760) 443-1397
Fax
(951) 695-2161
NPI assigned
May 2, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LISAC-11360 AZ
Mental Health Counselor 101YM0800X LPCC12138 CA Primary

Addresses

Primary practice location

32605 Temecula Pkwy
Suite 303
Temecula, CA 92592-6837

Mailing address

32605 Temecula Pkwy
Suite 303
Temecula, CA 92592-6837
Phone (760) 443-1397

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240109002129 CA Practitioner - Mental Health Counselor 3072964535 Practice locations: Temecula, CA

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

32605 Temecula Pkwy
Suite 303
Temecula, CA 92592-6840
Phone (760) 443-1397

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LISAC-11360AZMDAddiction (Substance Use Disorder) Counselor
LPCC12138CAMDMental Health Counselor
12138CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Compassionate Therapy Psychological Services, Inc. PastSince Sep 9, 2013 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": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660435200000",
    "number": "1639460181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32605 TEMECULA PKWY",
            "address_2": "SUITE 303",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925926837",
            "telephone_number": "760-443-1397",
            "fax_number": "951-695-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32605 TEMECULA PKWY",
            "address_2": "SUITE 303",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925926837",
            "telephone_number": "760-443-1397",
            "fax_number": "951-695-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YBARRA",
        "first_name": "PHILLIP",
        "middle_name": "B",
        "credential": "LPCC, LAADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-02",
        "last_updated": "2022-08-14",
        "certification_date": "2022-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC-11360",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LPCC12138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.