Avant-Garde Community Counseling Center

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MFC27861 Issued in CA

Legal business name

AVANT-GARDE COMMUNITY COUNSELING CENTER

Practice address

1655 E 6TH St Ste A5A
Corona, CA 92879-1719

Phone

(951) 735-5300

Fax

(951) 735-9335

NPI assigned

Sep 22, 2014

Last updated

Sep 23, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gregory Estravit

Title

Ceo

Phone

(951) 735-5300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kelly Felton

  • Clinical Social Worker
  • Temecula, CA
  • NPI 1073863304

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411430400000",
    "number": "1730581760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 E 6TH ST STE 117A5A",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928791732",
            "telephone_number": "951-735-5300",
            "fax_number": "951-735-9335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 E 6TH ST STE A5A",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928791719",
            "telephone_number": "951-735-5300",
            "fax_number": "951-735-9335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANT-GARDE COMMUNITY COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-22",
        "last_updated": "2014-09-23",
        "status": "A",
        "authorized_official_last_name": "ESTRAVIT",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-735-5300"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFC27861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORONA",
            "identifier": "659788",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Marie Avalos
• Irving Avalos
• Jasmine Brianna Avalos
• Samantha Avalos
• Avant Garde Community Counseling Center
• Avia Home Health Services Inc.
• Esther Avila, PA-C
• Sabrina Avila
• Avista Home Care
• Avista Home Care

• Mental Health Counselor in Corona, CA
• Providers in Corona, CA by specialty
• Mental Health Counselor in California

• 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.