John Nipper
Individual provider Active NPI Substance Abuse Rehabilitation Facility · Mira Loma, CA
NPI 1710285283 · NPPES record last updated Mar 8, 2011
Key facts
- NPI
- 1710285283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Substance Abuse Rehabilitation Facility 324500000X
- Practice address
- 11221 Holmes Ave
Mira Loma, CA 91752-2552 - Phone
- (951) 741-5004
- NPI assigned
- Mar 8, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | CA | Yes |
Addresses
Primary practice location
11221 Holmes Ave
Mira Loma, CA 91752-2552
Mailing address
11221 Holmes Ave
Mira Loma, CA 91752-2552
Phone (951) 741-5004
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101YA0400X | Other | CA | DOA COUNSELOR |
Other providers in Mira Loma, CA
- Erica Moore-Smith
- Steven Michael Morse
- Isabella Mwaura
- Judah Mwaura
- Phuongtam Ngoc Nguyen
- James E. O'Brien Jr.
- Winifred Olajide
- Nicole Ontiveros
- Chad Walter Petties Sr.
- Nancy Yvonne Piper
All providers in Mira Loma, CA · Substance Abuse Rehabilitation Facility in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.