NATIONAL COUNCIL ON ALCOHOLISM AND DRUG DEPENDENCE OF EAST SAN GABRIEL (NPI# 1417261983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417261983 |
| Entity Type | Organization |
| Organization Name | NATIONAL COUNCIL ON ALCOHOLISM AND DRUG DEPENDENCE OF EAST SAN GABRIEL |
| Other Organization Name | NCADD OF ESG & PV |
| Practice Address |
4626 North Grand Ave Covina CA 91724-2055 |
| Mailing Address |
4626 N. Grand Ave Covina CA 91724-2055 |
| Practice Telephone | 6263315316 |
| Practice Fax Number | 6263322219 |
| Mailing Telephone | 6263315316 |
| Mailing Fax Number | 6263322219 |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2010-07-27 |
| Authorized Official Name | MS. CHERYL ANN RVEDI (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6263315316 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
19-003-01-123 | CA | Behavioral Health & Social Service Providers |
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
190241CN | CA | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| NCADD of ESG & PV | Doing Business As Name - Organization |
| Street Address |
4626 NORTH GRAND AVE |
| City | COVINA |
| State | CA |
| Zip Code | 91724-2055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902320922 | Kimberly Suzanne Manzanares-mora | Rehabilitation Practitioner | 1359 North Grand Avenue, Covina, CA 91724 | 2017-08-01 |
| 1689194680 | Cynthia Garcia | Counselor | 1359 N. Grand Ave., Covina, CA 91724 | 2017-06-21 |
| 1386191963 | West Covina Group Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1274 Center Court Dr, #208, Covina, CA 91724 | 2016-09-01 |
| 1184094781 | Veronica May Roberts | Licensed Vocational Nurse | 222 S. Wilson Ave, Covina, CA 91724 | 2015-09-25 |
| 1912216292 | Joan Mendoza | Social Worker | 1338 Center Court Dr Ste 107, Covina, CA 91724 | 2010-10-04 |
| 1548583602 | Lille-anne Nzeribe | Rehabilitation Practitioner | 1126 N. Grand Ave. Suite D, Covina, CA 91724 | 2010-03-03 |
| 1154534212 | Verna L Lewis | Marriage & Family Therapist | 420 South Grand Ave., Covina, CA 91724 | 2007-05-07 |
| 1093937310 | Heather Annn Pedevillano | Specialist/Technologist | 1805 E. Lomira Dr, Covina, CA 91724 | 2007-05-03 |
| 1669503579 | Maritza Mercedes Reyes | Rehabilitation Practitioner | 1411 N. Grand Ave., Covina, CA 91724 | 2007-03-09 |
| 1417014085 | Bernadette Luyun Guaring Bagay | Dentist | 984 E Badillo St, Suite E, Covina, CA 91724 | 2007-01-03 |
| Find all providers in zip 91724 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568822617 | Gloria Adams | Counselor | 200 W Rowland St Apt 225, Covina, CA 91723-2972 | 2016-03-02 |
| 1023483120 | Christopher Nava | Counselor | 16742 E Benwood St, Covina, CA 91722-2416 | 2015-12-01 |
| 1679840649 | Andrea Anita Terrazas | Counselor | 343 N Prospero Dr Apt 3, Covina, CA 91723-2360 | 2011-11-18 |
| 1285941849 | James A Blumenschein | Counselor | 540 S Eremland Dr Ste A, Covina, CA 91723-3186 | 2010-09-02 |
| 1518286186 | Angelica Maria Moreno | Counselor | 505 S 1st Ave, Apt. 3, Covina, CA 91723-3160 | 2010-05-21 |
| 1689862625 | Elvira Quintana | Counselor | 16708 E Benwood St, Covina, CA 91722-2416 | 2007-10-03 |
| 1710196183 | Anna Laurie Cheek | Counselor | 1147 E Wanamaker Dr, Apt. A, Covina, CA 91724-3043 | 2007-05-22 |
| 1205979325 | Jimmie Charles Andrews | Counselor | 736 E Workman St Apt C, Covina, CA 91723-3645 | 2007-02-15 |
| 1295335149 | Marisol Barraza | Counselor | 4626 N Grand Ave, Covina, CA 91724-2055 | 2020-10-29 |
| 1538782487 | Jessica M Lopez Barrera | Counselor | 17727 E Cypress St, Covina, CA 91722-2634 | 2020-05-27 |
| Find all providers in COVINA | ||||
Please comment or provide details below to improve the information on NATIONAL COUNCIL ON ALCOHOLISM AND DRUG DEPENDENCE OF EAST SAN GABRIEL.
| 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.