Active NPI
Stephanie Vera
- Professional Counselor
- Riverside, CA
National Provider Identifier
1912638875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 17255
- Practice address
- 3125 Myers St
Riverside, CA 92503-5527 - Phone
- (951) 358-7086
- NPI assigned
- Jun 22, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | 17255 | CA | Primary |
Addresses
Primary practice location
3125 Myers St
Riverside, CA 92503-5527
Mailing address
13788 Golden Eagle CT
Moreno Valley, CA 92553-6035
Phone (951) 385-2761
Other practice location 1
1845 Chicago Ave Ste A
Riverside, CA 92507-2366
Phone (951) 686-7273
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 |
|---|---|---|---|
| 17255 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724716800000",
"number": "1912638875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13788 GOLDEN EAGLE CT",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925536035",
"telephone_number": "951-385-2761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3125 MYERS ST",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925035527",
"telephone_number": "951-358-7086"
}
],
"practiceLocations": [
{
"address_1": "1845 Chicago Ave Ste A",
"address_purpose": "LOCATION",
"city": "Riverside",
"state": "CA",
"postal_code": "925072366",
"country_code": "US",
"telephone_number": "951-686-7273",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VERA",
"first_name": "STEPHANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-22",
"last_updated": "2024-08-27",
"certification_date": "2024-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "17255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.