RETH SAM PROM NPI 1316674005

NPI Information

  • NPI: 1316674005
  • Provider Name: RETH SAM PROM
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 2501 ATLANTIC AVE
    LONG BEACH, CA
    ZIP 90806
  • Phone: (562) 424-6105

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NPI Details

Reth Sam Prom is an addiction (substance use disorder) counselor in Long Beach, CA. Reth Sam Prom NPI is 1316674005. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2501 ATLANTIC AVE
LONG BEACH, CA
ZIP 90806-708
Phone: (562) 424-6105

The enumeration date for this NPI number is 8/3/2022 and was last updated on 8/3/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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