MR. JOSE DE LA CRUZ (NPI# 1104205699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104205699 |
| Entity Type | Individual |
| Full Name | MR. JOSE DE LA CRUZ |
| Practice Address |
45550 Grace St Indio CA 92201-4610 |
| Practice Telephone | 7603421233 |
| Practice Fax Number | 7603224554 |
| Mailing Telephone | 7603421233 |
| Mailing Fax Number | 7603224554 |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2015-05-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CADTP#1483 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164987202 | Jose De La Cruz Sr. | Behavioral Analyst | 61 Fenner Ave, Clifton, NJ 07013-1049 | 2019-02-03 |
| 1629635073 | Jose Miguel De La Cruz | Social Worker | 6900 Tavistock Lakes Blvd Ste 400, Orlando, FL 32827-7593 | 2019-05-21 |
| 1033182548 | Jose J De La Cruz | Ophthalmology | 243 Charles St, Boston, MA 02114-3002 | 2006-02-08 |
| Street Address |
45550 GRACE ST |
| City | INDIO |
| State | CA |
| Zip Code | 92201-4610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811173792 | The Awareness Program | Counselor | 45550 Grace St, Indio, CA 92201-4610 | 2008-01-10 |
| 1295115095 | Stephen Dyllon Reeder | Counselor | 45550 Grace St, Indio, CA 92201-4610 | 2015-06-05 |
| 1902299894 | Lupe Duran | Counselor | 45550 Grace St, Indio, CA 92201-4610 | 2015-03-17 |
| 1417200924 | Todd R Nelson | Counselor | 45550 Grace St, Indio, CA 92201-4610 | 2012-10-22 |
| 1346406188 | Anthony Addeo | Counselor | 45550 Grace St, Indio, CA 92201-4610 | 2008-07-31 |
| 1497931307 | Mary Dehar | Counselor | 45550 Grace St, Indio, CA 92201-4610 | 2008-01-10 |
| 1538345434 | Fernando Montoya | Counselor | 45550 Grace St, Indio, CA 92201-4610 | 2008-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174151534 | Kayla Marie Berry | Licensed Vocational Nurse | Telecare Riverside County Psychiatric Health Facility, Indio, CA 92201 | 2020-03-31 |
| 1699327353 | Nawar Hadid | Dentist | 81735 Ca-111, Indio, CA 92201 | 2019-07-12 |
| 1427521889 | Thanh Trang Thi Nguyen Md Inc | Internal Medicine | 44100 Jefferson St., #e507, Indio, CA 92201 | 2019-01-09 |
| 1306328315 | Grant Nishimura | Dentist | 81-637, Suite 1, Ca-111, Indio, CA 92201 | 2018-09-06 |
| 1700363645 | Desert Physical Medicine | General Practice | 81765 Highway 111, Ste #3, Indio, CA 92201 | 2018-07-24 |
| 1336668151 | U & I Care Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 44105 Jackson St Ste 204, Indio, CA 92201 | 2017-09-13 |
| 1154847234 | Myung Kee Park | Dentist | 81106 Ca-111, #c, Indio, CA 92201 | 2017-08-21 |
| 1912434937 | Mirage Home Health | Home Health | 82691 Miles Ave, Indio, CA 92201 | 2017-05-22 |
| 1497294821 | Orthopedic and Physical Medicine Associates Inc | Chiropractor | 81765 Hwy 111, #3, Indio, CA 92201 | 2017-02-17 |
| 1497103758 | Timothy Smith | Contractor | 81337 Avenida Romero, Indio, CA 92201 | 2016-05-27 |
| Find all providers in zip 92201 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811417025 | Johnny Joseph Courreges | Counselor | 44-359 Palm St, Indio, CA 92201-9220 | 2017-06-20 |
| 1164829586 | Fernando Quiroz | Counselor | 23912 Avenue 45, Suite 9, Indio, CA 92201-3338 | 2014-12-01 |
| 1811173792 | The Awareness Program | Counselor | 45550 Grace St, Indio, CA 92201-4610 | 2008-01-10 |
| 1679759567 | Guillermo Simo | Counselor | 45926 Oasis Street, Indio, CA 92201-4610 | 2008-01-10 |
| 1194916221 | Rachelle Lynn Wiedeman | Counselor | 83912 Avenue 45 Ste B, Indio, CA 92201-3338 | 2007-08-05 |
| 1134343742 | Fritz M Solis | Counselor | 44199 Monroe St, Indio, CA 92201-3094 | 2007-04-13 |
| 1265572630 | Pio B Dingle Jr. | Counselor | 83921 Avenue 45, Suite 9, Indio, CA 92201 | 2007-02-07 |
| 1356480040 | Socorro Sanchez | Counselor | 83912 Avenue 45 Ste 9, Indio, CA 92201-3338 | 2007-02-06 |
| 1376158238 | Teresa Torres Bastidas | Counselor | 43485 Hollyhock St, Indio, CA 92201-1976 | 2020-09-08 |
| 1023622198 | Dominick Cardillo | Counselor | 83844 Hopi Ave, Indio, CA 92203-2638 | 2020-09-04 |
| Find all providers in INDIO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.