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NPI Code Detail

MEDICARE: DEBORAH PORTILLO ANGEL RADT-I

MEDICARE: DEBORAH PORTILLO ANGEL RADT-I
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCA

General Provider Information

NPI Number : 1477391795
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH PORTILLO ANGEL RADT-I
Provider Business Mailing Address
First Line : 5870 ARLINGTON AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92504-2037
Country : US
Telephone Number : 866-218-4697
Fax Number :
Provider Business Practice Location Address
First Line : 5870 ARLINGTON AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92504-2037
Country : US
Telephone Number : 866-218-4697
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2024
Last Update Date : 02/06/2026

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Directions to “ DEBORAH PORTILLO ANGEL RADT-I” Practice Location

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