Adrienne Peralta, SUD COUNSELOR

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

205 W 9TH St
San Pedro, CA 90731-3711

Phone

(310) 521-9209

NPI assigned

Jul 14, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• House of Hope Foundation, Inc.

  • Substance Abuse Rehabilitation Facility
  • San Pedro, CA
  • NPI 1740627843
  NPD (past)

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1720650138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 W 18TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907314506",
            "telephone_number": "424-305-9746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W 9TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313711",
            "telephone_number": "310-521-9209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2235 E Garvey Ave N",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917911540",
            "country_code": "US",
            "telephone_number": "626-337-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERALTA",
        "first_name": "ADRIENNE",
        "credential": "SUD COUNSELOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-14",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peninsula Eyecare Medical Associates (Peninsula Eyecare Medical Assoc)
• Peninsula Outpatient Surgery Center, Inc.
• Peninsula Pharmacy
• Vicki Penny, NP
• Blair Phillip Peoples, M.D.
• Ellaine Peralta
• Josue Pereira
• Mayra Perez Gonzalez
• Johanna Perez
• Monica Stephanie Perez

• Addiction (Substance Use Disorder) Counselor in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.