Alonzo Eison IV

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

SUDRC18607 Issued in CA

Practice address

14715 East Hwy 20
Clearlake Oaks, CA 95453

Phone

(707) 998-1800

Fax

(707) 998-0122

NPI assigned

Jul 18, 2024

Last updated

Jul 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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.

• Hilltop Recovery Services

  • Substance Abuse Rehabilitation Facility
  • Clearlake Oaks, CA
  • NPI 1578866323
  NPD (past)

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1811735277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 316",
            "city": "LUCERNE",
            "state": "CA",
            "postal_code": "954580316",
            "telephone_number": "707-998-1800",
            "fax_number": "707-998-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14715 EAST HWY 20",
            "city": "CLEARLAKE OAKS",
            "state": "CA",
            "postal_code": "95453",
            "telephone_number": "707-998-1800",
            "fax_number": "707-998-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISON",
        "first_name": "ALONZO",
        "name_suffix": "IV",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "SUDRC18607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• County of Lake (Big Oak Peer Support Center)
• Breanna Raquelle Cruz
• Celia M Drill, B.A., M.F.A., BCBA
• Charlene Jean Duncan
• East Lake Elementary
• Shawn Edward Fox
• Christopher Daniel Fraser
• Heather Sue Gerber
• Christy Lyree Hernandez
• Hilltop Recovery Services

• Addiction (Substance Use Disorder) Counselor in Clearlake Oaks, CA
• Providers in Clearlake Oaks, 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 Jul 18, 2024; 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.