Active NPI
Bailey Michelle Pruneda
- Peer Specialist
- San Diego, CA
National Provider Identifier
1730864174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 8755 Aero Dr Ste 230
San Diego, CA 92123-1750 - Phone
- (858) 256-2180
- NPI assigned
- Jun 21, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Peer Specialist | 175T00000X | MPSS-YTKZBS | CA | |
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
8755 Aero Dr Ste 230
San Diego, CA 92123-1750
Mailing address
8755 Aero Dr Ste 230
San Diego, CA 92123-1750
Phone (858) 256-2180
Other practice location 1
5610 Kitsap Way Ste 320
Bremerton, WA 98312-2266
Phone (360) 792-2020
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 |
|---|---|---|---|
| MPSS-YTKZBS | CA | MD | Peer Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Catholic Community Services of Western Washington | Current | Accepting new patients | |
| New Alternatives, Incorporated | Past | Accepting new patients |
Locations
5610 Kitsap Way
Ste 320
Bremerton, WA 98312
Phone (360) 792-2020
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Bremerton, WA
- NPI 1427580646
-
- Adolescent and Children Mental Health Clinic/Center
- San Diego, CA
- NPI 1023221470
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741737600000",
"number": "1730864174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8755 AERO DR STE 230",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231750",
"telephone_number": "858-256-2180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8755 AERO DR STE 230",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231750",
"telephone_number": "858-256-2180"
}
],
"practiceLocations": [
{
"address_1": "5610 Kitsap Way Ste 320",
"address_purpose": "LOCATION",
"city": "Bremerton",
"state": "WA",
"postal_code": "983122266",
"country_code": "US",
"telephone_number": "360-792-2020",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PRUNEDA",
"first_name": "BAILEY",
"middle_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-21",
"last_updated": "2025-03-12",
"certification_date": "2025-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "CA",
"license": "MPSS-YTKZBS",
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.