Individual provider Active NPI

Angela Venetis-Colon, PH.D.

  • Clinical Psychologist
  • Pasadena, CA
National Provider Identifier
1396087326
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY21455 Issued in CA
Practice address
680 E Colorado Blvd Ste 180&2ND
Pasadena, CA 91101-6143
Phone
(559) 385-0540
NPI assigned
Mar 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY21455 CA Primary

Addresses

Primary practice location

680 E Colorado Blvd Ste 180&2ND
Pasadena, CA 91101-6143

Mailing address

5131 W Menlo Ave
Fresno, CA 93722-3644
Phone (559) 385-0540

Other practice location 1

1 Kings Way
Avenal, CA 93204-9708
Phone (559) 386-0587 ext. 5630

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
I20250710003036 CA Practitioner - Clinical Psychologist 3870007719 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY21455CAMDClinical Psychologist
21455CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Reedley Community Hospital CurrentSince Jul 1, 2025 Accepting new patients
Reedley Community Hospital CurrentSince Jul 1, 2025 Accepting new patients
Corrections and Rehabilitation-Headquarters PastSince Mar 22, 2020 Accepting new patients

Locations

372 W Cypress Ave
Reedley, CA 93654
Phone (559) 391-3110

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1363305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1396087326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5131 W MENLO AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937223644",
            "telephone_number": "559-385-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 E COLORADO BLVD STE 180&2ND",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911016143",
            "telephone_number": "559-385-0540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Kings Way",
            "address_purpose": "LOCATION",
            "city": "Avenal",
            "state": "CA",
            "postal_code": "932049708",
            "country_code": "US",
            "telephone_number": "559-386-0587 x5630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VENETIS-COLON",
        "first_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-15",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY21455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.