Individual provider Active NPI

Rosa Arevalo

  • Rehabilitation Practitioner
  • Encino, CA
National Provider Identifier
1689325698
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
16500 Ventura Blvd Ste 414
Encino, CA 91436-5050
Phone
(818) 788-1003
NPI assigned
Jan 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Behavior Technician 106S00000X
Student in an Organized Health Care Education/Training Program 390200000X CA
Rehabilitation Practitioner 225400000X CA Primary

Addresses

Primary practice location

16500 Ventura Blvd Ste 414
Encino, CA 91436-5050

Mailing address

14649 Saticoy St Apt 212
Van Nuys, CA 91405-1256
Phone (818) 966-7827

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": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1689325698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14649 SATICOY ST APT 212",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914051256",
            "telephone_number": "818-966-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16500 VENTURA BLVD STE 414",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914365050",
            "telephone_number": "818-788-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AREVALO",
        "first_name": "ROSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.