Individual provider Active NPI

Evelyn Ponce Rangel, MSW, ACSW

  • Counselor
  • Coachella, CA
National Provider Identifier
1003570243
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
101395 Issued in CA
Practice address
50249 Cesar Chavez St Ste K
Coachella, CA 92236-1530
Phone
(760) 393-0555
Fax
(760) 393-0522
NPI assigned
Oct 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 101395 CA
Clinical Social Worker 1041C0700X
Counselor 101Y00000X 101395 CA Primary

Addresses

Primary practice location

50249 Cesar Chavez St Ste K
Coachella, CA 92236-1530

Mailing address

50249 Cesar Chavez St Ste K
Coachella, CA 92236-1530
Phone (760) 393-0555

Other practice location 1

525 Technology Ct Ste 105
Riverside, CA 92507-2181
Phone (951) 686-8500 ext. 4145

Other practice location 2

1908 Business Center Dr
San Bernardino, CA 92408-3436
Phone (909) 890-5930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Victor Community Support Services, Inc. CurrentSince Oct 1, 2021 Accepting new patients
Olive Crest PastSince Jul 1, 2022 Accepting new patients

Locations

1908 Business Center Dr
San Bernardino, CA 92408
Phone (909) 890-5930

Interoperability endpoints

  • Direct secure messaging: evelyn.rangelponce.p1@direct.cdsdp.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1003570243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50249 CESAR CHAVEZ ST STE K",
            "city": "COACHELLA",
            "state": "CA",
            "postal_code": "922361530",
            "telephone_number": "760-393-0555",
            "fax_number": "760-393-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50249 CESAR CHAVEZ ST STE K",
            "city": "COACHELLA",
            "state": "CA",
            "postal_code": "922361530",
            "telephone_number": "760-393-0555",
            "fax_number": "760-393-0522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 Technology Ct Ste 105",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925072181",
            "country_code": "US",
            "telephone_number": "951-686-8500 x4145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1908 Business Center Dr",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924083436",
            "country_code": "US",
            "telephone_number": "909-890-5930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PONCE RANGEL",
        "first_name": "EVELYN",
        "credential": "MSW, ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "101395",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "101395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coachella, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.