Jason Dean Phillips, SUDCC-II 6264

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1600 Bailey Ave
Needles, CA 92363-3105

Phone

(760) 326-9321

Fax

(760) 326-3154

NPI assigned

Oct 26, 2015

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 19, 2025.

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1992177299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 H ST",
            "city": "NEEDLES",
            "state": "CA",
            "postal_code": "923632928",
            "telephone_number": "760-326-4590",
            "fax_number": "760-326-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 BAILEY AVE",
            "city": "NEEDLES",
            "state": "CA",
            "postal_code": "923633105",
            "telephone_number": "760-326-9321",
            "fax_number": "760-326-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JASON",
        "middle_name": "DEAN",
        "credential": "SUDCC-II 6264",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-26",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Needles Medical Management Center Inc
• Pacific Clinics
• Mistydae Paget
• Juan Carlos Pequeno, MD
• Czarina Lim Perello, MSN-FNP
• Premier Emergency Physicians of California Medical Group PC
• Principal-Needles Inc
• Principal-Needles Inc
• Martin Robert Reid, RPH
• Melissa Rempp

• All providers in Needles, CA
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.