Individual provider Active NPI

Evelin Guevara

  • Marriage & Family Therapist
  • Costa Mesa, CA
National Provider Identifier
1043613789
Registry record updated Oct 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMF81556 Issued in CA
Practice address
1503 S Coast Dr
Suit 202
Costa Mesa, CA 92626-1534
Phone
(949) 515-5440
Fax
(949) 515-5444
NPI assigned
Oct 8, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2014

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 IMF81556 CA Primary

Addresses

Primary practice location

1503 S Coast Dr
Suit 202
Costa Mesa, CA 92626-1534

Mailing address

51 Gavilan
Rancho Santa Margarita, CA 92688-1601
Phone (949) 275-0420

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
IMF81556CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412726400000",
    "number": "1043613789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 GAVILAN",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926881601",
            "telephone_number": "949-275-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 S COAST DR",
            "address_2": "SUIT 202",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261534",
            "telephone_number": "949-515-5440",
            "fax_number": "949-515-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUEVARA",
        "first_name": "EVELIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-08",
        "last_updated": "2014-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF81556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; 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.