Active NPI
Patrick Ezeli
- School Counselor
- Upland, CA
National Provider Identifier
1710644828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Counselor
- License
- 4A1B143F93
- Practice address
- 601 5TH Ave
Upland, CA 91786-4839 - Phone
- (909) 949-7800
- NPI assigned
- Nov 23, 2021
- Last updated
- Oct 10, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Counselor | 101YS0200X | 4A1B143F93 | CA | Primary |
Addresses
Primary practice location
601 5TH Ave
Upland, CA 91786-4839
Mailing address
7184 Castle Rock Way
Roseville, CA 95747-8979
Phone (424) 353-1376
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 |
|---|---|---|---|
| 4A1B143F93 | CA | MD | School Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760054400000",
"number": "1710644828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7184 CASTLE ROCK WAY",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "957478979",
"telephone_number": "424-353-1376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 5TH AVE",
"city": "UPLAND",
"state": "CA",
"postal_code": "917864839",
"telephone_number": "909-949-7800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZELI",
"first_name": "PATRICK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-23",
"last_updated": "2025-10-10",
"certification_date": "2025-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": "CA",
"license": "4A1B143F93",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Upland, CA
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- Cecilia Fabris, MFTI
- Michael Christian Fabro
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.