Individual provider Active NPI

Elani Aquino, MSW

  • Psychologist
  • Santa Cruz, CA
National Provider Identifier
1407900897
Registry record updated Aug 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LCS20450 Issued in CA
Practice address
104 Walnut Ave Ste 208
Santa Cruz, CA 95060-3929
Phone
(831) 423-9444
Fax
(831) 423-1532
NPI assigned
Jan 22, 2007
Last updated
Aug 13, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LCS20450 CA Primary

Addresses

Primary practice location

104 Walnut Ave Ste 208
Santa Cruz, CA 95060-3929

Mailing address

1612 Bay St
Santa Cruz, CA 95060
Phone (831) 426-2880

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
20450CAMDPsychologist
LCS20450CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service Agency of the Central Coast Psychologist PastSince Oct 26, 2005 Accepting new patients

Organizations & group practices 1

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250121600000",
    "number": "1407900897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 BAY ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "95060",
            "telephone_number": "831-426-2880",
            "fax_number": "831-477-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 WALNUT AVE STE 208",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603929",
            "telephone_number": "831-423-9444",
            "fax_number": "831-423-1532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AQUINO",
        "first_name": "ELANI",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2009-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "LCS20450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2009; 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.