Individual provider Active NPI

Angelique N Celestine, LMFT

  • Marriage & Family Therapist
  • Riverside, CA
National Provider Identifier
1164804134
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
127202 Issued in CA
Practice address
3625 14TH St
Riverside, CA 92501-3815
Phone
(951) 955-1540
Fax
(951) 955-1610
NPI assigned
Jun 25, 2015
Last updated
Sep 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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 127202 CA Primary

Addresses

Primary practice location

3625 14TH St
Riverside, CA 92501-3815

Mailing address

3625 14TH St
Riverside, CA 92501-3815
Phone (519) 551-5409

Other names 1

  • Angelique C Cameron Former name

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
I20260402002034 CA Practitioner - Marriage and Family Therapist 5496230823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3617 Merrill Ave
Apt 235
Riverside, CA 92506-2536

PO Box
Suite 2016
Riverside, CA 92516

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hope and Wellness Family Counseling Marriage & Family Therapist Current Accepting new patients
A Tender Love and Care Inc Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1164804134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 14TH ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013815",
            "telephone_number": "519-551-5409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 14TH ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013815",
            "telephone_number": "951-955-1540",
            "fax_number": "951-955-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CELESTINE",
        "first_name": "ANGELIQUE",
        "middle_name": "N",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "127202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELIQUE",
            "last_name": "CAMERON",
            "middle_name": "C",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.