Active NPI
Ezekiel Elizalde
- Addiction (Substance Use Disorder) Counselor
- Visalia, CA
National Provider Identifier
1740732437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- B6980291
- Practice address
- 220 N Locust St
Visalia, CA 93291-4946 - Phone
- (559) 627-1385
- Fax
- (559) 636-2105
- NPI assigned
- Oct 27, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | B6980291 | CA | Primary |
Addresses
Primary practice location
220 N Locust St
Visalia, CA 93291-4946
Mailing address
220 N Locust St
Visalia, CA 93291-4946
Phone (559) 627-1385
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5478 | Other | CA | MEDICAL |
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 |
|---|---|---|---|
| B6980291 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477526400000",
"number": "1740732437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 N LOCUST ST",
"city": "VISALIA",
"state": "CA",
"postal_code": "932914946",
"telephone_number": "559-627-1385",
"fax_number": "559-636-2105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 N LOCUST ST",
"city": "VISALIA",
"state": "CA",
"postal_code": "932914946",
"telephone_number": "559-627-1385",
"fax_number": "559-636-2105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELIZALDE",
"first_name": "EZEKIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-27",
"last_updated": "2016-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "B6980291",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "5478",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Visalia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.