Naziem Dalton Flanigan

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1401370820 Issued in CA

Practice address

4450 W Century Blvd
Inglewood, CA 90304-1504

Phone

(310) 671-9294

NPI assigned

May 13, 2021

Last updated

May 13, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1730753922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 W CENTURY BLVD",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903041504",
            "telephone_number": "310-671-9294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 W CENTURY BLVD",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903041504",
            "telephone_number": "310-671-9294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANIGAN",
        "first_name": "NAZIEM",
        "middle_name": "DALTON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-13",
        "last_updated": "2021-05-13",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1401370820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ID",
            "identifier": "F4605487",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Inglewood",
            "affiliation": "N",
            "address_1": "4450 W Century Blvd",
            "city": "Inglewood",
            "state": "CA",
            "country_code": "US",
            "postal_code": "903041504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Inglewood, CA
• Providers in Inglewood, 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 13, 2021; 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.