Anthony Jason Avila

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

2080 S E St
San Bernardino, CA 92408-2773

Phone

(909) 388-9191

NPI assigned

Mar 10, 2021

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

Practice roles

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.

• Aegis Treatment Centers, LLC

  • Methadone Clinic
  • Hesperia, CA
  • NPI 1215373055
  NPD (past)
• Telecare Corporation

  • Health Maintenance Organization
  • San Bernardino, CA
  • NPI 1770741282
  NPD (past)

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1689259731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 S E ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082773",
            "telephone_number": "909-388-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 S E ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082773",
            "telephone_number": "909-388-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA",
        "first_name": "ANTHONY",
        "middle_name": "JASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avant Infusion LLC
• Agustin Ulises Avantes, B.A.
• Yasmin Alejandra Avendano
• Lamont Avery
• Andrea Avila Silva
• Christal Avila
• Jessica Avila
• Jose Avila
• Mark Avila
• Priscilla Avila

• Community Health Worker in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.