Active NPI
Jennifer Daine Gibbons
- Addiction (Substance Use Disorder) Counselor
- Hesperia, CA
National Provider Identifier
1770770810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 11776 Mariposa Rd
Hesperia, CA 92345-1622 - Phone
- (760) 956-2462
- NPI assigned
- Oct 3, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
11776 Mariposa Rd
Hesperia, CA 92345-1622
Mailing address
9675 Mignonette St
Alta Loma, CA 91701-5027
Phone (909) 636-1788
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Los Angeles County Department of Public Health | Current | Accepting new patients | |
| Nationwide Medical Group, Inc | Past | Accepting new patients |
Interoperability endpoints
- jennifergibbons-aegistreatmentcenters@lacsapc.netsmartdirect.net
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.
-
- Public Health or Welfare Agency
- Alhambra, CA
- NPI 1700090834
-
- Community Health Clinic/Center
- Stockton, CA
- NPI 1548317951
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412640000000",
"number": "1770770810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9675 MIGNONETTE ST",
"city": "ALTA LOMA",
"state": "CA",
"postal_code": "917015027",
"telephone_number": "909-636-1788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11776 MARIPOSA RD",
"city": "HESPERIA",
"state": "CA",
"postal_code": "923451622",
"telephone_number": "760-956-2462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBONS",
"first_name": "JENNIFER",
"middle_name": "DAINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-03",
"last_updated": "2014-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hesperia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.