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11821 Foothill Blvd

Addiction (Substance Use Disorder) Counselor in Los Angeles, CA · enumerated 2012 · authorized official Derrick Fortune, Counselor.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1164767356

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Registry record

Entity type Organization (Type 2)
Legal business name 11821 Foothill Blvd
Practice address 5436 S. Broadway, Los Angeles, CA, 90037
Phone (818) 694-7206
Enumeration date Nov 29, 2012
Last updated in NPPES Nov 29, 2012

Taxonomy & classification

101YA0400X Addiction (Substance Use Disorder) Counselor Behavioral Health & Social Service Providers Primary

Authorized official

Name Derrick Fortune
Title Counselor
Phone (818) 694-7206

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is 11821 Foothill Blvd located?
The practice location on file with NPPES is in Los Angeles, CA.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2012-11-29. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2012-11-29.