Individual provider · Type 1 NPI

Itzia Adilene Basulto Montes

Peer Specialist · Yucca Valley, CA

NPI number 1790652162 Active

Practice location

58457 Twentynine Palms Highway, Suite 102A
Yucca Valley, CA 92284

Call (760) 228-9657 Map

Fax (442) 205-0060

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000XMPSS-VMFYNA (CA)
Day Training/Habilitation Specialist 373H00000XNone listed

Peer Specialist: 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.

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About NPI 1790652162

Itzia Adilene Basulto Montes's National Provider Identifier is 1790652162, issued on Oct 21, 2025. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Yucca Valley, CA. The record was last updated on Jun 18, 2026.