Active NPI
Roger B Wiford, ADC
- Addiction (Substance Use Disorder) Counselor
- Fontana, CA
National Provider Identifier
1720106537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CAADE 030817
- Practice address
- 7993 Sierra Ave
Fontana, CA 92336-3330 - Phone
- (909) 822-8720
- Fax
- (909) 822-8438
- NPI assigned
- Mar 27, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CAADE 030817 | CA | Primary |
Addresses
Primary practice location
7993 Sierra Ave
Fontana, CA 92336-3330
Mailing address
7956 Spohn Ave
Fontana, CA 92336-2851
Phone (909) 356-8645
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 |
|---|---|---|---|
| CAADE 030817 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720106537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7956 SPOHN AVE",
"city": "FONTANA",
"state": "CA",
"postal_code": "923362851",
"telephone_number": "909-356-8645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7993 SIERRA AVE",
"city": "FONTANA",
"state": "CA",
"postal_code": "923363330",
"telephone_number": "909-822-8720",
"fax_number": "909-822-8438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIFORD",
"first_name": "ROGER",
"middle_name": "B",
"credential": "ADC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "CAADE 030817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fontana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.