Bobby Lee Taunton III, CADC-II, ICADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

A049920618 Issued in CA

Practice address

1539 Carolyn CT
Redlands, CA 92374-4738

Phone

(909) 413-4304

NPI assigned

Nov 19, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Destiny Recovery Center, LLC

  • Substance Abuse Rehabilitation Facility
  • Redlands, CA
  • NPI 1114393832
  NPD

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

{
    "created_epoch": "1542585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1922577030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 AARON DR",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923743811",
            "telephone_number": "334-799-9186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1539 CAROLYN CT",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744738",
            "telephone_number": "909-413-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAUNTON",
        "first_name": "BOBBY",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "CADC-II, ICADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A049920618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCAPP",
            "identifier": "A049920618",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pei-Yuen Tang, D.O.
• Bronika Vardeh Tarmani
• Jessica Lee Tarrats
• Robert K. Tarter, M.D.
• Steve Tatevossian, DDS FAACP
• Poonam Tavkar-Conley, PH.D.
• Alisa Leanne Taylor
• Clifford D. Taylor, PH.D.
• Constance Marie Taylor, PH.D.
• Karissa Madison Taylor

• Addiction (Substance Use Disorder) Counselor in Redlands, CA
• Providers in Redlands, 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 Sep 19, 2023; 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.