Active NPI
Jonathan A Corea, RADT
- Addiction (Substance Use Disorder) Counselor
- Auburn, CA
National Provider Identifier
1861910523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- R1260230817
- Practice address
- 12183 Locksley LN Ste 101
Auburn, CA 95602-2050 - Phone
- (503) 885-1961
- NPI assigned
- Sep 1, 2017
- Sex
- Male
- 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 | R1260230817 | CA | Primary |
Addresses
Primary practice location
12183 Locksley LN Ste 101
Auburn, CA 95602-2050
Mailing address
12183 Locksley LN Ste 101
Auburn, CA 95602-2050
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
| License | State | Type | Specialty |
|---|---|---|---|
| R1260230817 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504224000000",
"number": "1861910523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12183 LOCKSLEY LN STE 101",
"city": "AUBURN",
"state": "CA",
"postal_code": "956022050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12183 LOCKSLEY LN STE 101",
"city": "AUBURN",
"state": "CA",
"postal_code": "956022050",
"telephone_number": "503-885-1961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COREA",
"first_name": "JONATHAN",
"middle_name": "A",
"credential": "RADT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-01",
"last_updated": "2017-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R1260230817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.