Individual provider Active NPI

Marlon Ponce

  • Community Health Worker
  • La Palma, CA
National Provider Identifier
1003584707
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
20 Centerpointe Dr Ste 130
La Palma, CA 90623-2562
Phone
(657) 325-8313
NPI assigned
Aug 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X CA Primary

Addresses

Primary practice location

20 Centerpointe Dr Ste 130
La Palma, CA 90623-2562

Mailing address

20 Centerpointe Dr Ste 130
La Palma, CA 90623-2562
Phone (657) 261-7140

Other practice location 1

12141 Brookhurst St Ste 201
Garden Grove, CA 92840-2865
Phone (657) 261-7140

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
Telecare Corporation CurrentSince Apr 14, 2024 Accepting new patients
Telecare Corporation CurrentSince Jun 1, 2023 Accepting new patients
Love 2 Learn Consulting LLC Behavior Technician PastSince Nov 9, 2021 Accepting new patients

Locations

12141 Brookhurst St
Ste 201
Garden Grove, CA 92840
Phone (657) 261-7140

20 Centerpointe Dr
Ste 130
La Palma, CA 90623
Phone (657) 325-8313

Organizations & group practices 3

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": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1003584707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CENTERPOINTE DR STE 130",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906232562",
            "telephone_number": "657-261-7140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CENTERPOINTE DR STE 130",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906232562",
            "telephone_number": "657-325-8313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12141 Brookhurst St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Garden Grove",
            "state": "CA",
            "postal_code": "928402865",
            "country_code": "US",
            "telephone_number": "657-261-7140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PONCE",
        "first_name": "MARLON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Palma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.