Individual provider Active NPI

Desiree Castaneda Angulo

  • Student in an Organized Health Care Education/Training Program
  • Victorville, CA
National Provider Identifier
1649986803
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
15345 Bonanza Rd
Victorville, CA 92392-2499
Phone
(909) 387-7380
NPI assigned
Jan 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Case Manager/Care Coordinator 171M00000X
Student in an Organized Health Care Education/Training Program 390200000X CA Primary
Rehabilitation Practitioner 225400000X

Addresses

Primary practice location

15345 Bonanza Rd
Victorville, CA 92392-2499

Mailing address

15175 Lake St
Adelanto, CA 92301-4818
Phone (760) 265-0435

Other practice location 1

1556 S Sultana Ave
Ontario, CA 91761-4238
Phone (909) 418-6923

Other practice location 2

755 E Gilbert
San Bernardino, CA 92415-2499
Phone (909) 387-7380

Other practice location 3

1950 S Sunwest Lane Suite 200
San Bernardino, CA 92418-2499
Phone (909) 252-4044

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Bernardino PastSince Feb 1, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1649986803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15175 LAKE ST",
            "city": "ADELANTO",
            "state": "CA",
            "postal_code": "923014818",
            "telephone_number": "760-265-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15345 BONANZA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922499",
            "telephone_number": "909-387-7380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1556 S Sultana Ave",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "CA",
            "postal_code": "917614238",
            "country_code": "US",
            "telephone_number": "909-418-6923",
            "fax_number": "909-418-6937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "755 E Gilbert",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924152499",
            "country_code": "US",
            "telephone_number": "909-387-7380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1950 S Sunwest Lane Suite 200",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924182499",
            "country_code": "US",
            "telephone_number": "909-252-4044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANGULO",
        "first_name": "DESIREE",
        "middle_name": "CASTANEDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.