Arla Provo

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

C14781214 Issued in CA

Practice address

13525 Cielo Azul Way
Desert Hot Springs, CA 92240-6235

Phone

(760) 329-4619

NPI assigned

Oct 19, 2020

Last updated

Oct 19, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

State licenses

Practice roles

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

• Hemmat Health, PC

  • Addiction Medicine (Preventive Medicine) Physician
  • Rolling Hills Estates, CA
  • NPI 1508619420
  NPD (past)
• Soroptimist House of Hope, Inc

  • Substance Abuse Rehabilitation Facility
  • Desert Hot Springs, CA
  • NPI 1710277694
  NPD (past)

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1770182917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13525 CIELO AZUL WAY",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922406235",
            "telephone_number": "760-329-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13525 CIELO AZUL WAY",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922406235",
            "telephone_number": "760-329-4619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVO",
        "first_name": "ARLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "C14781214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Pontonuwu, PT
• Lakeithea Anne Porter
• Maryam Poursartip, M.D.
• Antonia Pridemore
• John Prince, PPS: COUNSELOR
• Micaela Denise Pugliese
• Maegan Pummell
• Amy Herma Rabinowitz, R.N.
• Imani Mariella Rachal
• Tiffany Raith, DC

• Addiction (Substance Use Disorder) Counselor in Desert Hot Springs, CA
• Providers in Desert Hot Springs, 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 Oct 19, 2020; 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.