Individual provider Active NPI

Guadalupe Gastelum

  • Behavior Analyst
  • Moreno Valley, CA
National Provider Identifier
1083850846
Registry record updated Dec 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
13800 Heacock St
Suite C236
Moreno Valley, CA 92553-3339
Phone
(951) 653-0819
Fax
(951) 656-2614
NPI assigned
Dec 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

13800 Heacock St
Suite C236
Moreno Valley, CA 92553-3339

Mailing address

35234 Eureka Ave
Yucaipa, CA 92399-4783
Phone (909) 810-7936

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Clinics Past Accepting new patients

Organizations & group practices 1

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": "1230508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293062400000",
    "number": "1083850846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35234 EUREKA AVE",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923994783",
            "telephone_number": "909-810-7936",
            "fax_number": "909-797-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13800 HEACOCK ST",
            "address_2": "SUITE C236",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533339",
            "telephone_number": "951-653-0819",
            "fax_number": "951-656-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASTELUM",
        "first_name": "GUADALUPE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-29",
        "last_updated": "2010-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2010; 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.