Active NPI
J-Rah Poblano
- Addiction (Substance Use Disorder) Counselor
- Pasadena, CA
National Provider Identifier
1881283703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- R1417860121
- Practice address
- 1450 N Lake Ave Ste 150
Pasadena, CA 91104-2388 - Phone
- (818) 203-2901
- NPI assigned
- Jan 14, 2021
- Sex
- Female
- 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 | R1417860121 | CA | Primary |
Addresses
Primary practice location
1450 N Lake Ave Ste 150
Pasadena, CA 91104-2388
Mailing address
1450 N Lake Ave Ste 150
Pasadena, CA 91104-2388
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881283703 | Other | NATIONAL PLAN AND PROVIDER ENUMERATION SYSTEM |
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 |
|---|---|---|---|
| R1417860121 | 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": "1610582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649980800000",
"number": "1881283703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1450 N LAKE AVE STE 150",
"city": "PASADENA",
"state": "CA",
"postal_code": "911042388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 N LAKE AVE STE 150",
"city": "PASADENA",
"state": "CA",
"postal_code": "911042388",
"telephone_number": "818-203-2901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POBLANO",
"first_name": "J-RAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-14",
"last_updated": "2022-04-15",
"certification_date": "2022-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R1417860121",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL PLAN AND PROVIDER ENUMERATION SYSTEM",
"identifier": "1881283703",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.