Active NPI
Tina Apodaca
- Addiction (Substance Use Disorder) Counselor
- Vallejo, CA
National Provider Identifier
1922762012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- R1412621220
- Practice address
- 419 Pennsylvania St
Vallejo, CA 94590-6933 - Phone
- (707) 643-2715
- Fax
- (707) 643-8536
- NPI assigned
- Oct 26, 2021
- Sex
- Female
- 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 | R1412621220 | CA | Primary |
Addresses
Primary practice location
419 Pennsylvania St
Vallejo, CA 94590-6933
Mailing address
419 Pennsylvania St # a
Vallejo, CA 94590-6933
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R1412621220 | Other | CA | CCAPP |
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 |
|---|---|---|---|
| R1412621220 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635206400000",
"number": "1922762012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "419 PENNSYLVANIA ST # A",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945906933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "419 PENNSYLVANIA ST",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945906933",
"telephone_number": "707-643-2715",
"fax_number": "707-643-8536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "APODACA",
"first_name": "TINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-26",
"last_updated": "2021-10-26",
"certification_date": "2021-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R1412621220",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CCAPP",
"identifier": "R1412621220",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.