Jeffrey Anderson, CADC-CS, ICCS, ICADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

555 S Palm Canyon Dr Ste A202
Palm Springs, CA 92264-7210

Phone

(760) 892-4538

Fax

(760) 318-0610

NPI assigned

Jan 4, 2016

Last updated

Mar 17, 2018By 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

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.

• Pacifica Recovery Inc

  • Substance Abuse Rehabilitation Facility
  • Palm Springs, CA
  • NPI 1639663230

  Addiction (Substance Use Disorder)

  NPD (past)
• Pacifica Recovery, Inc.

  • Substance Abuse Rehabilitation Facility
  • Palm Desert, CA
  • NPI 1366936825
  NPD (past)

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

{
    "created_epoch": "1451865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1891151015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S PALM CANYON DR STE A202",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922647210",
            "telephone_number": "760-892-4538",
            "fax_number": "760-318-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S PALM CANYON DR STE A202",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922647210",
            "telephone_number": "760-892-4538",
            "fax_number": "760-318-0610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "280 E Mel Ave",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922624817",
            "country_code": "US",
            "telephone_number": "760-892-4538",
            "fax_number": "760-318-0610",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "74200 Fairway Dr",
            "address_purpose": "LOCATION",
            "city": "Palm Desert",
            "state": "CA",
            "postal_code": "922604949",
            "country_code": "US",
            "telephone_number": "760-892-4538",
            "fax_number": "760-318-0610",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 N D St",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924103524",
            "country_code": "US",
            "telephone_number": "909-381-3774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JEFFREY",
        "credential": "CADC-CS, ICCS, ICADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-04",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew James Ancheta, PHARM.D.
• Pisey E. Ancheta, PHAM.D.
• Danielle Ray B Anciro, MD
• Brian Leroy Anderson, M.D
• Charles Edward Anderson Jr., MD
• Jill Nicole Anderson, RDH
• Ryan Anderson, O.D.
• Ursula Gertrude Anderson, MFT INTERN
• Karla Andrade
• Andrew J. Fragen, MD, Facs, Inc.

• Addiction (Substance Use Disorder) Counselor in Palm Springs, CA
• Providers in Palm Springs, 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 Mar 17, 2018; 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.