Individual provider Active NPI

Jose Renteria

  • Addiction (Substance Use Disorder) Counselor
  • La Puente, CA
National Provider Identifier
1720480650
Registry record updated Sep 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
RW7465 Issued in CA
Practice address
15229 Amar Rd
La Puente, CA 91744-2066
Phone
(626) 855-5090
Fax
(626) 961-1810
NPI assigned
Sep 23, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X RW7465 CA Primary

Addresses

Primary practice location

15229 Amar Rd
La Puente, CA 91744-2066

Mailing address

15229 Amar Rd
La Puente, CA 91744-2066
Phone (626) 855-5090

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

LicenseStateTypeSpecialty
RW7465CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1720480650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15229 AMAR RD",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917442066",
            "telephone_number": "626-855-5090",
            "fax_number": "626-961-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15229 AMAR RD",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917442066",
            "telephone_number": "626-855-5090",
            "fax_number": "626-961-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENTERIA",
        "first_name": "JOSE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-23",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "RW7465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Puente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; 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.