Pes-Ebs.Inc.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

PES-EBS.INC.

Practice address

2060 Chicago Ave Ste A9
Riverside, CA 92507-2316

Phone

(530) 888-1010

NPI assigned

Dec 24, 2018

Organization subpart

No

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

Authorized official

Name

Walter Stockman

Title

President

Phone

(530) 888-1010

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Pes-Ebsinc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pes-Ebs.Inc.

  • Community/Behavioral Health Agency
  • Santa Ana, CA
  • NPI 1851763882
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Raul Diaz

  • Addiction (Substance Use Disorder) Counselor
  • San Bernardino, CA
  • NPI 1700465507
  NPD (past)

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

{
    "created_epoch": "1545609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554249600000",
    "number": "1881166296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11837 KEMPER RD STE 2",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956039067",
            "telephone_number": "530-888-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 CHICAGO AVE STE A9",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072316",
            "telephone_number": "530-888-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PES-EBS.INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-24",
        "last_updated": "2019-04-03",
        "status": "A",
        "authorized_official_last_name": "STOCKMAN",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-888-1010"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8048",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanaisha Nicole Perry
• Allyza Perryman
• Michael Blake Perryman, DPT
• Jon Persichino, D.O.
• Marlene Personett
• Richard Dominic Pesavento, M.D.
• Peter P. Kim
• Peter Y. Chang, M.D., PH.D., Inc.
• Brooke Marie Peterman, BA
• Jason Howard Peterman, RN

• Substance Use Disorder Rehabilitation Clinic/Center in Riverside, CA
• Providers in Riverside, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; 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.