Individual provider Active NPI

Jessica Magallanes-Evans, PSYD

  • Clinical Psychologist
  • Santa Cruz, CA
National Provider Identifier
1619203205
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY28238 Issued in CA
Practice address
1156 High St
Santa Cruz, CA 95064-1099
Phone
(831) 459-2628
Fax
(831) 459-5116
NPI assigned
Nov 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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 PSY28238 CA Primary

Addresses

Primary practice location

1156 High St
Santa Cruz, CA 95064-1099

Mailing address

1156 High St
Santa Cruz, CA 95064-1099
Phone (831) 459-2628

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
I20260306002185 CA Practitioner - Clinical Psychologist 8527540681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1100 Trancas St
Suite 256
Napa, CA 94558-2921
Phone (707) 253-7161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY28238CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Mar 1, 2026 Accepting new patients
Providence Medical Foundation CurrentSince Mar 1, 2026 Accepting new patients

Locations

1100 Trancas St
Ste 256
Napa, CA 94558
Phone (707) 253-7161

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": "1257120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1619203205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1156 HIGH ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950641099",
            "telephone_number": "831-459-2628",
            "fax_number": "831-459-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 HIGH ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950641099",
            "telephone_number": "831-459-2628",
            "fax_number": "831-459-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGALLANES-EVANS",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-02",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY28238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.