Individual provider Active NPI

Paloma Velez, LCSW

  • Mental Health Counselor
  • Colton, CA
National Provider Identifier
1326173055
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCS 22834 Issued in CA
Practice address
1330 E Cooley Dr
Colton, CA 92324-3905
Phone
(909) 463-5196
NPI assigned
Feb 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCS 22834 CA Primary

Addresses

Primary practice location

1330 E Cooley Dr
Colton, CA 92324-3905

Mailing address

1330 E Cooley Dr
Colton, CA 92324-3905
Phone (909) 463-5196

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
I20190501002026 CA Practitioner - Clinical Social Worker 8123360740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

8710 Monroe CT
Suite 150
Rancho Cucamonga, CA 91730-4885
Phone (909) 941-4870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 22834CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Psychiatric Medical Group, Inc. CurrentSince Apr 8, 2019 Accepting new patients
Inland Psychiatric Medical Group, Inc CurrentSince Apr 8, 2019 Accepting new patients
Inland Psychiatric Medical Group, Inc. Current Accepting new patients

Locations

8710 Monroe Ct
Ste 150
Rancho Cucamonga, CA 91730
Phone (909) 941-4870

1809 W Redlands Blvd
Redlands, CA 92373
Phone (909) 307-1320

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326173055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 E COOLEY DR",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923243905",
            "telephone_number": "909-463-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 E COOLEY DR",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923243905",
            "telephone_number": "909-463-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELEZ",
        "first_name": "PALOMA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LCS 22834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.