Active NPI
Kevin Nolasco
- Community Health Worker
- Victorville, CA
National Provider Identifier
1023688553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 15497 W Sand St
Victorville, CA 92392-2910 - Phone
- (909) 490-5991
- NPI assigned
- Jun 28, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
15497 W Sand St
Victorville, CA 92392-2910
Mailing address
15497 W Sand St
Victorville, CA 92392-2910
Phone (909) 490-5991
Other practice location 1
2929 Fm 2920 Rd
Spring, TX 77388-3428
Phone (281) 210-1500
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kevin.nolasco@arrow.org | ||
| Direct Messaging Address | knolasco@highdesertpsych.com |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738022400000",
"number": "1023688553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15497 W SAND ST",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923922910",
"telephone_number": "909-490-5991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15497 W SAND ST",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923922910",
"telephone_number": "909-490-5991"
}
],
"practiceLocations": [
{
"address_1": "2929 Fm 2920 Rd",
"address_purpose": "LOCATION",
"city": "Spring",
"state": "TX",
"postal_code": "773883428",
"country_code": "US",
"telephone_number": "281-210-1500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NOLASCO",
"first_name": "KEVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-28",
"last_updated": "2025-01-28",
"certification_date": "2025-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kevin.nolasco@arrow.org",
"affiliation": "N",
"endpointDescription": "E-mail",
"address_1": "2929 Fm 2920 Rd",
"city": "Spring",
"state": "TX",
"country_code": "US",
"postal_code": "773883428",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "knolasco@highdesertpsych.com",
"affiliation": "N",
"endpointDescription": "E-Mail",
"address_1": "15497 W Sand St",
"city": "Victorville",
"state": "CA",
"country_code": "US",
"postal_code": "923922910",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.