Brian Jordan Sobocinski, RADT-1

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CI27210419 Issued in CA

Practice address

2986 Coloma St
Placerville, CA 95667-4441

Phone

(530) 748-3706

NPI assigned

Mar 13, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1520899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1780187054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 BEACH CT.",
            "city": "LOTUS",
            "state": "CA",
            "postal_code": "956514441",
            "telephone_number": "530-626-7252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2986 COLOMA ST",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956674441",
            "telephone_number": "530-748-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBOCINSKI",
        "first_name": "BRIAN",
        "middle_name": "JORDAN",
        "credential": "RADT-1",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-13",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "CI27210419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Placerville, CA
• Providers in Placerville, 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 11, 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.