Active NPI
Evelyn Romero
- Community Health Worker
- Marina, CA
National Provider Identifier
1477274256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- E1681314
- Practice address
- 299 12TH St
Marina, CA 93933-6003 - Phone
- (831) 883-3030
- NPI assigned
- Sep 8, 2022
- Last updated
- May 16, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Community Health Worker | 172V00000X | E1681314 | CA | Primary |
Addresses
Primary practice location
299 12TH St
Marina, CA 93933-6003
Mailing address
299 12TH St
Marina, CA 93933-6003
Phone (831) 883-3030
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E1681314 | CA | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684195200000",
"number": "1477274256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "299 12TH ST",
"city": "MARINA",
"state": "CA",
"postal_code": "939336003",
"telephone_number": "831-883-3030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "299 12TH ST",
"city": "MARINA",
"state": "CA",
"postal_code": "939336003",
"telephone_number": "831-883-3030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROMERO",
"first_name": "EVELYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-08",
"last_updated": "2023-05-16",
"certification_date": "2023-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "CA",
"license": "E1681314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.