Active NPI
Reketta Earlene Nesmith
- Professional Counselor
- Apple Valley, CA
National Provider Identifier
1689949372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 9651
- Practice address
- 17800 US Highway 18
Apple Valley, CA 92307-1221 - Phone
- (760) 946-8200
- Fax
- (760) 946-8208
- NPI assigned
- Mar 14, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 2368 | CA | |
| Professional Counselor | 101YP2500X | 9651 | CA | Primary |
Addresses
Primary practice location
17800 US Highway 18
Apple Valley, CA 92307-1221
Mailing address
17800 US Highway 18
Apple Valley, CA 92307-1221
Phone (760) 946-8200
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9651 | CA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621468800000",
"number": "1689949372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17800 US HIGHWAY 18",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "923071221",
"telephone_number": "760-946-8200",
"fax_number": "760-946-8208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17800 US HIGHWAY 18",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "923071221",
"telephone_number": "760-946-8200",
"fax_number": "760-946-8208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NESMITH",
"first_name": "REKETTA",
"middle_name": "EARLENE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-14",
"last_updated": "2021-05-20",
"certification_date": "2021-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "2368",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "9651",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Apple Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.