Individual provider · Type 1 NPI

Edgar Ontiveros

Peer Specialist · Clearlake, CA

NPI number 1891517124 Active

Practice location

14096 Lakeshore Dr
Clearlake, CA 95422-8160

Call (707) 994-4261 Map

Mailing address

PO Box 1024
Lucerne, CA 95458-1024

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000XMPSS-WEYLRB (CA)

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 1891517124

Edgar Ontiveros's National Provider Identifier is 1891517124, issued on Oct 28, 2024. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Clearlake, CA. The record was last updated on Oct 30, 2024.