Healthcare Provider Details

I. General information

NPI: 1699154989
Provider Name (Legal Business Name): KAMI RHEBA WINSTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2015
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2085 RUSTIN AVE
RIVERSIDE CA
92507-2498
US

IV. Provider business mailing address

450 E SAN JACINTO AVE STE 3
PERRIS CA
92571-2833
US

V. Phone/Fax

Practice location:
  • Phone: 951-955-2146
  • Fax:
Mailing address:
  • Phone: 951-955-2146
  • Fax: 951-704-7923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberC051880418
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: