Edward Guisande Arevalo, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A49719 Issued in CA

Practice address

3262 Holiday CT
Suite 200
La Jolla, CA 92037-0026

Phone

(858) 922-3057

NPI assigned

Jan 15, 2007

Last updated

Jun 30, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pathways Community Services LLCGroup PAC ID 9830368687, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pathways Community Services LLC

  dba CYS Clarvida - Fullerton

  • Community/Behavioral Health Agency
  • Fullerton, CA
  • NPI 1881729911
  Medicare reassignment Care Compare group NPD
• Pathways Community Services LLC

  dba CYS Clarvida - Tustin

  • Community/Behavioral Health Agency
  • Tustin, CA
  • NPI 1396436077
  NPD
• Pathways Community Services LLC

  dba Clarvida

  • Community/Behavioral Health Agency
  • Lancaster, CA
  • NPI 1720225360
  NPD
• Pathways Community Services LLC

  dba Clarvida

  • Community/Behavioral Health Agency
  • Pico Rivera, CA
  • NPI 1639364862
  NPD (past)

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1225189343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270472",
            "address_2": "SUITE 113, PMB 234",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921982472",
            "telephone_number": "858-922-3057",
            "fax_number": "858-300-0461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3262 HOLIDAY CT",
            "address_2": "SUITE 200",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920370026",
            "telephone_number": "858-922-3057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AREVALO",
        "first_name": "EDWARD",
        "middle_name": "GUISANDE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A49719",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A49719",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "FF873A",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PTAN",
            "identifier": "FH539Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alba Racheal Araujo
• Nasrin Arbabi
• Christian Francis Archambault, MD
• Katya Archambault, DMD
• Solana Rose Archuleta, MD
• Shilpa Pramod Argade, MD
• Babak Ariannejad, DMD
• Shahab Ariannejad, D.M.D.
• Ginger Villareal Armas, PHD
• Bruce W. Armstrong, P.A.-C. , MHS

• Psychiatry Physician in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.