Active NPI
Albert Carrasco, CADC II
- Addiction (Substance Use Disorder) Counselor
- San Jose, CA
National Provider Identifier
1922420504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 102 S 11TH St
San Jose, CA 95112-2132 - Phone
- (408) 998-5191
- NPI assigned
- Jan 15, 2014
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
102 S 11TH St
San Jose, CA 95112-2132
Mailing address
611 Kiely Blvd
Santa Clara, CA 95051
Phone (408) 510-9409
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathway Society Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Substance Abuse Rehabilitation Facility
- San Jose, CA
- NPI 1902194095
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506038400000",
"number": "1922420504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 KIELY BLVD",
"city": "SANTA CLARA",
"state": "CA",
"postal_code": "95051",
"telephone_number": "408-510-9409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 S 11TH ST",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951122132",
"telephone_number": "408-998-5191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRASCO",
"first_name": "ALBERT",
"credential": "CADC II",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-01-15",
"last_updated": "2017-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.