Individual provider Active NPI

Elisha Harris

  • Addiction (Substance Use Disorder) Counselor
  • Riverside, CA
National Provider Identifier
1790204022
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LCI12610618 Issued in CA
Practice address
6860 Brockton Ave Ste 9
Riverside, CA 92506-3816
Phone
(951) 312-5904
NPI assigned
Sep 19, 2017
Last updated
Jan 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCI12610618 CA Primary

Addresses

Primary practice location

6860 Brockton Ave Ste 9
Riverside, CA 92506-3816

Mailing address

3100 Van Buren Blvd Apt 624
Riverside, CA 92503-5680
Phone (909) 218-9239

Other practice location 1

835 Anira Ct
Perris, CA 92571-5113
Phone (951) 653-3000

Other practice location 2

13941 Courage St
Moreno Valley, CA 92553-8757
Phone (951) 653-3000

Other practice location 3

14340 Elsworth St Ste 108&109
Moreno Valley, CA 92553-9019
Phone (951) 653-3000

Other practice location 4

13921 Courage St
Moreno Valley, CA 92553-8757
Phone (951) 653-3000

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

LicenseStateTypeSpecialty
LCI12610618CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mfi Recovery Center PastSince Jul 23, 2023 Accepting new patients
Immanuel Sobriety Inc. PastSince Dec 8, 2024 Accepting new patients
Immanuel Sobriety Inc. PastSince Dec 8, 2024 Accepting new patients
Immanuel Sobriety Inc. PastSince Dec 8, 2024 Accepting new patients
G & C Swan Inc PastSince Jan 26, 2025 Accepting new patients
G & C Swan Inc PastSince Dec 1, 2021 Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1790204022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 VAN BUREN BLVD APT 624",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035680",
            "telephone_number": "909-218-9239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6860 BROCKTON AVE STE 9",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063816",
            "telephone_number": "951-312-5904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "835 Anira Ct",
            "address_purpose": "LOCATION",
            "city": "Perris",
            "state": "CA",
            "postal_code": "925715113",
            "country_code": "US",
            "telephone_number": "951-653-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13941 Courage St",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925538757",
            "country_code": "US",
            "telephone_number": "951-653-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14340 Elsworth St Ste 108&109",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925539019",
            "country_code": "US",
            "telephone_number": "951-653-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13921 Courage St",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925538757",
            "country_code": "US",
            "telephone_number": "951-653-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ELISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-19",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "LCI12610618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; 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.