Active NPI
Mackenzie Lucinda Bello Ponce
- Community Health Worker
- Ontario, CA
National Provider Identifier
1083263396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 316 E E St
Ontario, CA 91764-3712 - Phone
- (909) 983-4466
- NPI assigned
- Sep 9, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
316 E E St
Ontario, CA 91764-3712
Mailing address
6879 Green Ave
Riverside, CA 92503-1315
Phone (951) 347-2419
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": "1567987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567987200000",
"number": "1083263396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6879 GREEN AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925031315",
"telephone_number": "951-347-2419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 E E ST",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917643712",
"telephone_number": "909-983-4466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELLO PONCE",
"first_name": "MACKENZIE",
"middle_name": "LUCINDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-09",
"last_updated": "2019-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.