Healthcare Provider Details

I. General information

NPI: 1326970849
Provider Name (Legal Business Name): JOSE LUIS NARANJO SUDRC# 25753
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOSE LUIS NARANJO SUDRC# 25753

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11500 PARAMOUNT BLVD
DOWNEY CA
90241-4530
US

IV. Provider business mailing address

11500 PARAMOUNT BLVD
DOWNEY CA
90241-4530
US

V. Phone/Fax

Practice location:
  • Phone: 562-923-4545
  • Fax:
Mailing address:
  • Phone: 562-923-4545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-PAQVOS
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number25753
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: