Active NPI
Mackenzie Van
- Peer Specialist
- Indio, CA
National Provider Identifier
1033971593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 47915 Oasis St Unit C
Indio, CA 92201-6950 - Phone
- (442) 282-4909
- NPI assigned
- Jan 29, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | |||
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
47915 Oasis St Unit C
Indio, CA 92201-6950
Mailing address
PO Box 13084
Palm Desert, CA 92255-3084
Phone (760) 289-2212
Other practice location 1
47915 Oasis St
Indio, CA 92201-6950
Phone (760) 863-8650
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": "1706486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756771200000",
"number": "1033971593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 13084",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922553084",
"telephone_number": "760-289-2212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47915 OASIS ST UNIT C",
"city": "INDIO",
"state": "CA",
"postal_code": "922016950",
"telephone_number": "442-282-4909"
}
],
"practiceLocations": [
{
"address_1": "47915 Oasis St",
"address_purpose": "LOCATION",
"city": "Indio",
"state": "CA",
"postal_code": "922016950",
"country_code": "US",
"telephone_number": "760-863-8650",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VAN",
"first_name": "MACKENZIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-29",
"last_updated": "2025-09-02",
"certification_date": "2025-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": null,
"license": null,
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indio, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.