Individual provider Active NPI

Tianna Jaye Harris

  • Addiction (Substance Use Disorder) Counselor
  • Moreno Valley, CA
National Provider Identifier
1679470629
Registry record updated Oct 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
R161594025 Issued in CA
Practice address
13941 Courage St
Moreno Valley, CA 92553-8757
Phone
(951) 653-3000
NPI assigned
Oct 22, 2026
Last updated
Oct 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2026

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 R161594025 CA Primary

Addresses

Primary practice location

13941 Courage St
Moreno Valley, CA 92553-8757

Mailing address

23185 Calle Nogales
239
Moreno Valley, CA 92557

Other practice location 1

835 Anira Ct
Perris, CA 92571-5113
Phone (951) 653-3000

Other practice location 2

14340 Elsworth St Ste 8
Moreno Valley, CA 92553-9019
Phone (951) 653-3000

Other practice location 3

13921 Courage St
Moreno Valley, CA 92553-8757
Phone (951) 653-3000

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

Practice roles

OrganizationSpecialtyStatusNew patients
Immanuel Sobriety Inc. PastSince Dec 8, 2024 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, 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": "1792627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792627200000",
    "number": "1679470629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23185 CALLE NOGALES",
            "address_2": "239",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "92557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13941 COURAGE ST",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925538757",
            "telephone_number": "951-653-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "835 Anira Ct",
            "address_purpose": "LOCATION",
            "city": "Perris",
            "state": "CA",
            "postal_code": "925715113",
            "country_code": "US",
            "telephone_number": "951-653-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14340 Elsworth St Ste 8",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925539019",
            "country_code": "US",
            "telephone_number": "951-653-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13921 Courage St",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925538757",
            "country_code": "US",
            "telephone_number": "951-653-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "TIANNA",
        "middle_name": "JAYE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-22",
        "last_updated": "2026-10-22",
        "certification_date": "2026-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R161594025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2026; 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.