Individual provider Active NPI

Ana Rayo, LMFT

  • Marriage & Family Therapist
  • Moreno Valley, CA
National Provider Identifier
1073899365
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
85534 Issued in CA
Practice address
12815 Heacock St
Moreno Valley, CA 92553
Phone
(951) 601-6261
NPI assigned
Oct 31, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 85534 CA Primary
Marriage & Family Therapist 106H00000X IMF67645 CA

Addresses

Primary practice location

12815 Heacock St
Moreno Valley, CA 92553

Mailing address

11815 Modena Dr
Rancho Cucamonga, CA 91701
Phone (909) 446-2840

Other names 1

  • Miss Ana L Rayo Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240502001902 CA Practitioner - Marriage and Family Therapist 6204276611 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IMF67645CAMDMarriage & Family Therapist
85534CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sud Specialty Group - Ca Marriage & Family Therapist CurrentSince Nov 1, 2025 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 19, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 19, 2024 Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

12815 Heacock St
Moreno Valley, CA 92553
Phone (951) 601-6174

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Organizations & group practices 5

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": "1320019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1073899365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11815 MODENA DR",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "91701",
            "telephone_number": "909-446-2840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12815 HEACOCK ST",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "92553",
            "telephone_number": "951-601-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYO",
        "first_name": "ANA",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-31",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "85534",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF67645",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANA",
            "last_name": "RAYO",
            "middle_name": "L",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.