Jason Anthony Cruz

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

4727 Issued in CA

Practice address

762 Griswold Ave
San Fernando, CA 91340-2105

Phone

(747) 500-9405

NPI assigned

Jun 16, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• San Fernando Recovery Center

  • Substance Abuse Rehabilitation Facility
  • San Fernando, CA
  • NPI 1164980603
  NPD (past)
• San Fernando Recovery Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • San Fernando, CA
  • NPI 1275478745
  NPD (past)

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1902474729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11443 EMELITA ST APT 100",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916011112",
            "telephone_number": "213-328-9785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 GRISWOLD AVE",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913402105",
            "telephone_number": "747-500-9405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2521 Long Beach Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900581324",
            "country_code": "US",
            "telephone_number": "213-529-9063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "JASON",
        "middle_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-16",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "4727",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "4727",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• County of Los Angeles Auditor Controller (San Fernando Health Center)
• County of Los Angeles Auditor Controller (San Fernando Health Center)
• Dora Elva Crespo I, RN
• Enrique Cristobal Meneses
• Rebecca Lee Cross, N.P.
• Daisy Cruzes, RBT
• Gerardo Cudich, L.AC.
• Emily Cuevas
• Ryan Curiel
• Victoria Curtin, LCSW

• Addiction (Substance Use Disorder) Counselor in San Fernando, CA
• Providers in San Fernando, 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 May 9, 2024; 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.