Active NPI
Kelly Bugarin
- Mental Health Counselor
- Chino Hills, CA
National Provider Identifier
1386299808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 109126
- Practice address
- 1907 Boys Republic Dr
Chino Hills, CA 91709-5447 - Phone
- (909) 628-1217
- Fax
- (909) 306-5427
- NPI assigned
- Aug 2, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 109126 | CA | Primary |
Addresses
Primary practice location
1907 Boys Republic Dr
Chino Hills, CA 91709-5447
Mailing address
1907 Boys Republic Dr
Chino Hills, CA 91709-5447
Phone (909) 628-1217
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659484800000",
"number": "1386299808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1907 BOYS REPUBLIC DR",
"city": "CHINO HILLS",
"state": "CA",
"postal_code": "917095447",
"telephone_number": "909-628-1217",
"fax_number": "909-306-5427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1907 BOYS REPUBLIC DR",
"city": "CHINO HILLS",
"state": "CA",
"postal_code": "917095447",
"telephone_number": "909-628-1217",
"fax_number": "909-306-5427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUGARIN",
"first_name": "KELLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-02",
"last_updated": "2022-08-03",
"certification_date": "2022-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "109126",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chino Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.