Active NPI
Jacob Souza
- Substance Abuse Rehabilitation Facility
- Long Beach, CA
National Provider Identifier
1902334360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Abuse Rehabilitation Facility
- Practice address
- 4340 Maury Ave
Long Beach, CA 90807-2537 - Phone
- (562) 270-6344
- NPI assigned
- May 30, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | CA | Primary |
Addresses
Primary practice location
4340 Maury Ave
Long Beach, CA 90807-2537
Mailing address
19072 Lindsay LN
Huntington Beach, CA 92646-2224
Phone (714) 403-5736
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496102400000",
"number": "1902334360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19072 LINDSAY LN",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926462224",
"telephone_number": "714-403-5736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4340 MAURY AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908072537",
"telephone_number": "562-270-6344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUZA",
"first_name": "JACOB",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-05-30",
"last_updated": "2017-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.