Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Edgar Ontiveros

Individual provider Peer Specialist · NPI 1891517124

Edgar Ontiveros is a Peer Specialist in Clearlake, California. Licensed in California. Registered with an NPI since 2024.

Licensed in
CA
In the registry since
2024

Practice location Address checks out

14096 Lakeshore Dr
Clearlake, CA 95422-8160
Phone: (707) 994-4261
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X · Licence MPSS-WEYLRB (CA)

Record details

NPI number1891517124
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 28, 2024
Last updated in NPPESOctober 30, 2024
Certification dateOctober 30, 2024
Mailing addressPo Box 1024, Lucerne, CA 95458-1024

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