Mario Guerrero Evangelista, B.A.

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

E0019818 Issued in CA

Practice address

300 N San Antonio Rd BLDG 3
Santa Barbara, CA 93110-1316

Phone

(805) 737-6629

NPI assigned

Dec 11, 2007

Last updated

Dec 11, 2007By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

State licenses

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1346423431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 E FESLER ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934544513",
            "telephone_number": "805-928-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N SAN ANTONIO RD BLDG 3",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931101316",
            "telephone_number": "805-737-6629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "MARIO",
        "middle_name": "GUERRERO",
        "name_prefix": "Mr.",
        "credential": "B.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "CA",
            "license": "E0019818",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "E0019818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Abella Estrada
• Marci Andrea Estrada
• Douglas A Etsell, M.D.
• Andrew Clinton Eubank
• Karen Eutsler Little, MS,CCC-SLP
• Zachary Payton Evangelista, DDS
• Amy Marie Evans, LMFT
• Bethany Evans
• Brooke P Evans
• Elisse Evans, ND

• Case Manager/Care Coordinator in Santa Barbara, CA
• Providers in Santa Barbara, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.