Active NPI
Victoria E Berruecos, BSW
- Mental Health Counselor
- Yuma, AZ
National Provider Identifier
1871247551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2197 S 4TH Ave Ste 202
Yuma, AZ 85364-6473 - Phone
- (928) 581-8624
- NPI assigned
- Feb 10, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | R1457610222 | CA | |
| Behavior Technician | 106S00000X | |||
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
2197 S 4TH Ave Ste 202
Yuma, AZ 85364-6473
Mailing address
192 N 5TH Ave
Yuma, AZ 85364-1320
Phone (559) 509-4090
Other practice location 1
705 S Court St
Visalia, CA 93277-2727
Phone (559) 635-8010
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://thjaz.org/ |
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 |
|---|---|---|---|
| R1457610222 | 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": "1644451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673308800000",
"number": "1871247551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "192 N 5TH AVE",
"city": "YUMA",
"state": "AZ",
"postal_code": "853641320",
"telephone_number": "559-509-4090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2197 S 4TH AVE STE 202",
"city": "YUMA",
"state": "AZ",
"postal_code": "853646473",
"telephone_number": "928-581-8624"
}
],
"practiceLocations": [
{
"address_1": "705 S Court St",
"address_purpose": "LOCATION",
"city": "Visalia",
"state": "CA",
"postal_code": "932772727",
"country_code": "US",
"telephone_number": "559-635-8010",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BERRUECOS",
"first_name": "VICTORIA",
"middle_name": "E",
"credential": "BSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-10",
"last_updated": "2023-01-10",
"certification_date": "2023-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R1457610222",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://thjaz.org/",
"affiliation": "N",
"address_1": "2197 S 4th Ave Ste 202",
"city": "Yuma",
"state": "AZ",
"country_code": "US",
"postal_code": "853646473",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Yuma, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.