Individual provider Active NPI

Esmeralda Gissele Puente, B.A

  • Peer Specialist
  • Lancaster, CA
National Provider Identifier
1124844774
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
MPSS-VKLOPA Issued in CA
Practice address
45111 Fern Ave
Lancaster, CA 93534-2301
Phone
(661) 949-1206
NPI assigned
Nov 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X MPSS-VKLOPA CA Primary

Addresses

Primary practice location

45111 Fern Ave
Lancaster, CA 93534-2301

Mailing address

45111 Fern Ave
Lancaster, CA 93534-2301
Phone (661) 949-1206

Other practice location 1

43520 Division St
Lancaster, CA 93535-4089
Phone (661) 266-4783

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
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
MPSS-VKLOPACAMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1732665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1124844774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45111 FERN AVE",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342301",
            "telephone_number": "661-949-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45111 FERN AVE",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342301",
            "telephone_number": "661-949-1206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43520 Division St",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "CA",
            "postal_code": "935354089",
            "country_code": "US",
            "telephone_number": "661-266-4783",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUENTE",
        "first_name": "ESMERALDA",
        "middle_name": "GISSELE",
        "name_prefix": "Miss",
        "credential": "B.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-27",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-VKLOPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; 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.