Kaeli Jordan Ilagan-Evangelista

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

5465 E 2ND St Apt 19
Long Beach, CA 90803-3912

Phone

(707) 567-7231

NPI assigned

Jul 26, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kiki Jordan Ilagan-Evangelista Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1235865932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5465 E 2ND ST APT 19",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908033912",
            "telephone_number": "707-567-7231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5465 E 2ND ST APT 19",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908033912",
            "telephone_number": "707-567-7231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILAGAN-EVANGELISTA",
        "first_name": "KAELI",
        "middle_name": "JORDAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-26",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIKI",
            "last_name": "ILAGAN-EVANGELISTA",
            "middle_name": "JORDAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ijeoma C. Igwe, D.D.S.
• Amauchechi Chidozie Ihenacho
• Holly Ihle, PH.D.
• Falastina Faye Ihmud
• Edafe Lans Alex Ikpuri
• Anna Victoria Flores Ilagan, MD
• Jewel Illis
• Illuminate Psychotherapy, a Marriage & Family Therapy Inc
• Agatha Ndudi Iloka, FNP
• George Oranyelu Ilouno

• Athletic Trainer in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Athletic Trainer in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; 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.