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NPI Code Detail

MEDICARE: ERNEST RODRIGUEZ BELLO RADT # R1583851024

MEDICARE: ERNEST RODRIGUEZ BELLO RADT # R1583851024
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2101YA0400XAddiction (Substance Use Disorder) CounselorR1583851024CA
3171400000XHealth & Wellness Coach
4171M00000XCase Manager/Care Coordinator
5175T00000XPeer SpecialistMPSS-FXZUKNCA
6172V00000XCommunity Health WorkerCA

General Provider Information

NPI Number : 1396592713
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERNEST RODRIGUEZ BELLO RADT # R1583851024
Provider Business Mailing Address
First Line : 8008 MAGNOLIA AVE APT 3
Second Line :
City : RIVERSIDE
State : CA
Zip : 92504-3449
Country : US
Telephone Number : 951-934-8183
Fax Number :
Provider Business Practice Location Address
First Line : 7344 MAGNOLIA AVE STE 110
Second Line :
City : RIVERSIDE
State : CA
Zip : 92504-3819
Country : US
Telephone Number : 805-622-7747
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2024
Last Update Date : 12/13/2024

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