BRODI THOMAS PETITT


Address: 3125 Myers St, Riverside, CA 92503-5527
Phone: 9519557829

BRODI THOMAS PETITT (NPI# 1417439910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1417439910
Entity Type Individual
Full Name BRODI THOMAS PETITT
Practice Address 3125 Myers St
Riverside
CA 92503-5527
Practice Telephone 9519557829
Mailing Telephone 9519557829
Enumeration Date 2018-08-30
Last Update Date 2018-08-30
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 175T00000X Peer Specialist Other Service Providers

Office Location

Street Address 3125 MYERS ST
City RIVERSIDE
State CA
Zip Code 92503-5527

Providers in the same location

NPI Name Taxonomy Address Enumeration
1407968068 Richard Joonkoo Lee Psychiatry & Neurology 3125 Myers St, Rcdmh Children's Treatment Services, Riverside, CA 92503-5527 2006-08-31
1821616616 Mayra Mariscal Case Manager/Care Coordinator 3125 Myers St, Riverside, CA 92503-5527 2020-07-08
1003434986 Marco Antonio Elias-juarez Marriage & Family Therapist 3125 Myers St, Riverside, CA 92503-5527 2020-07-08
1831723980 Kimberly N/a Franco Marriage & Family Therapist 3125 Myers St, Riverside, CA 92503-5527 2020-02-27
1609419860 Melissa Aimee Benson Marriage & Family Therapist 3125 Myers St, Riverside, CA 92503-5527 2019-10-21
1023678810 Aaron A Alonso Case Manager/Care Coordinator 3125 Myers St, Riverside, CA 92503-5527 2019-06-14
1730746371 Cassandra Rodriquez Counselor 3125 Myers St, Riverside, CA 92503 2019-05-20
1548745763 Eddy Anne Garcia Peer Specialist 3125 Myers St, Riverside, CA 92503-5527 2018-10-03
1053891101 Adriyel Angel Carrillo Counselor 3125 Myers St, Riverside, CA 92503-5527 2018-08-17
1942789508 Ana Bertha Ramirez-gutierrez Counselor 3125 Myers St, Riverside, CA 92503 2018-08-13
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1255953618 Mohammad Abul-fielat Dds Inc Dentist 3825 Tyler St, Riverside, CA 92503 2020-05-08
1205396488 Francisco Aguayo Behavioral Analyst 3345 Jackson St, Riverside, CA 92503 2019-03-22
1073071684 Racheal Ego Aneke Nurse Practitioner 9890 County Farm Rd., Building 2, Riverside, CA 92503 2019-03-04
1073070264 Luxottica of America Inc. Eyewear Supplier (Equipment, not the service) 3500 Tyler Mall, Riverside, CA 92503 2019-02-25
1053893271 Tsibel Dental Practice Inc. Dentist 10181 Magnolia Ave, Riverside, CA 92503 2018-09-04
1508344714 Patricia Marraine Redondo Counselor 1625 14th St, Riverside, CA 92503 2018-07-31
1740766146 Robles Rodef & Yaghoubi Dental Corporation Dentist 5628 Van Buren Blvd Suite #a, Riverside, CA 92503 2018-07-18
1467961755 Daniela Popa Assisted Living Facility 10820 Calle Bella, Riverside, CA 92503 2017-09-29
1457860306 Leah Dreany Peer Specialist 2085 Rustin Avenue Building #3, Riverside, CA 92503 2017-09-22
1710400445 Christopher John Guting Peer Specialist 10230 Indiana Avenue, Riverside, CA 92503 2017-07-25
Find all providers in zip 92503

Taxonomy Information

Taxonomy Code 175T00000X
Grouping Other Service Providers
Classification Peer Specialist

Taxonomy Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Notes: Source: National Uniform Claim Committee [7/1/2014: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1477047835 Deborah Kay Allen Peer Specialist 6939 Morningside Ave, Riverside, CA 92504 2018-06-19
1053802769 Miesha Hale Peer Specialist 1820 University Ave Ste 2b, Riverside, CA 92507-5355 2018-05-29
1538677612 Monica Munoz Peer Specialist 9991c County Farm Rd, Riverside, CA 92503-3506 2018-01-11
1457860306 Leah Dreany Peer Specialist 2085 Rustin Avenue Building #3, Riverside, CA 92503 2017-09-22
1043738099 Colene Lavonne Roberts Peer Specialist 9890 County Farm Rd # 2, Riverside, CA 92503-3505 2017-08-30
1710400445 Christopher John Guting Peer Specialist 10230 Indiana Avenue, Riverside, CA 92503 2017-07-25
1841713203 Denise Darlene Leeper Peer Specialist 771 W. Blaine St, Suite C., Riverside, CA 92507 2017-07-18
1427590058 Jennifer Hayford Peer Specialist 3250 Panorama Rd Apt 139, Riverside, CA 92506-1351 2016-11-14
1144693953 Michelle Elaine Martinez Peer Specialist 5012 Arlington Ave, Riverside, CA 92504-2710 2015-11-03
1558733824 Gina Irvin Peer Specialist 771 W Blaine St # C, Riverside, CA 92507-3940 2015-10-27
Find all providers in RIVERSIDE

Competitor

Search similar providers

City RIVERSIDE
Zip Code 92503

Improve Information

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Dataset Information

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.

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