Evelyn Angelica Fuentes

Primary specialty

TechnicianTaxonomy code 374700000X

Practice address

8142 Sunland Blvd
Sun Valley, CA 91352

Phone

(818) 306-4254

Fax

(818) 582-8836

NPI assigned

Jul 5, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• The Teen Project, Inc.

  dba Freehab CRTP

  • Mental Illness Community Based Residential Treatment Facility
  • Sun Valley, CA
  • NPI 1457908618
  NPD
• The Teen Project, Inc.

  • Substance Abuse Rehabilitation Facility
  • Sun Valley, CA
  • NPI 1194677880
  NPD (past)

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1245751718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10762 KESWICK ST",
            "city": "SUN VALLEY",
            "state": "CA",
            "postal_code": "913524606",
            "telephone_number": "818-823-4090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8142 SUNLAND BLVD",
            "city": "SUN VALLEY",
            "state": "CA",
            "postal_code": "91352",
            "telephone_number": "818-306-4254",
            "fax_number": "818-582-8836"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1147 S alvarado",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90006",
            "country_code": "US",
            "telephone_number": "213-381-8534 x210",
            "fax_number": "213-381-8533",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1135 S Alvarado St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900064100",
            "country_code": "US",
            "telephone_number": "213-381-8534 x210",
            "fax_number": "213-381-8533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "EVELYN",
        "middle_name": "ANGELICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-05",
        "last_updated": "2022-07-21",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R4718",
            "primary": false
        },
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Foothill Medical Transportation, Inc
• Anthony J Francis, M.D.
• Elizabeth Bustos Franco
• Franklin Hospice, Inc
• Elise Fryberger
• Tashara Fuentes
• Fun Valley Kids Dental Group (Fun Valley Kids dental)
• Fusion Child Development Center Inc.
• G & J Transportation
• G&L Home Inc (Fresh Start Living G&L)

• Technician in Sun Valley, CA
• Providers in Sun Valley, CA by specialty
• Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.