Individual provider Active NPI

Michael Angelo Peppers

  • Rehabilitation Practitioner
  • San Diego, CA
National Provider Identifier
1912886490
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
5473 Kearney Villa Rd Ste 300
San Diego, CA 92123-9212
Phone
(858) 298-7347
Fax
(619) 684-7004
NPI assigned
Aug 29, 2025
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 22900 CA
Rehabilitation Practitioner 225400000X CA Primary
Peer Specialist 175T00000X

Addresses

Primary practice location

5473 Kearney Villa Rd Ste 300
San Diego, CA 92123-9212

Mailing address

5473 Kearny Villa Rd Ste 300
San Diego, CA 92123-1142
Phone (858) 298-7347

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

LicenseStateTypeSpecialty
22900CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1756425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1912886490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5473 KEARNY VILLA RD STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231142",
            "telephone_number": "858-298-7347",
            "fax_number": "619-684-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5473 KEARNEY VILLA RD STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921239212",
            "telephone_number": "858-298-7347",
            "fax_number": "619-684-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEPPERS",
        "first_name": "MICHAEL",
        "middle_name": "ANGELO",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-29",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "22900",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; 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.