Individual provider Active NPI

James A Evangelista

  • Marriage & Family Therapist
  • Red Bluff, CA
National Provider Identifier
1013410265
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
139378 Issued in CA
Practice address
20 Antelope Boulevard
Red Bluff, CA 96080
Phone
(530) 567-7600
Fax
(530) 727-9094
NPI assigned
Mar 14, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 139378 CA Primary

Addresses

Primary practice location

20 Antelope Boulevard
Red Bluff, CA 96080

Mailing address

20 Antelope Boulevard
Red Bluff, CA 96080
Phone (530) 567-7600

Other practice location 1

2395 Bechelli Lane
Redding, CA 96002
Phone (360) 704-8483

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

State licenses

LicenseStateTypeSpecialty
139378CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Remi Vista, Inc. Marriage & Family Therapist CurrentSince Aug 25, 2024 Accepting new patients

Locations

20 Antelope Blvd
Red Bluff, CA 96080
Phone (530) 245-5805

Organizations & group practices 1

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": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1013410265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 ANTELOPE BOULEVARD",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "96080",
            "telephone_number": "530-567-7600",
            "fax_number": "530-727-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 ANTELOPE BOULEVARD",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "96080",
            "telephone_number": "530-567-7600",
            "fax_number": "530-727-9094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2395 Bechelli Lane",
            "address_purpose": "LOCATION",
            "city": "Redding",
            "state": "CA",
            "postal_code": "96002",
            "country_code": "US",
            "telephone_number": "360-704-8483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "JAMES",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-14",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "139378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bluff, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.