Individual provider Active NPI

Gladys Cecelia Guevara, CATC III

  • Student in an Organized Health Care Education/Training Program
  • Bloomington, CA
National Provider Identifier
1730655176
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
18612 Santa Ana Ave
Bloomington, CA 92316-2636
Phone
(909) 546-8099
NPI assigned
Oct 23, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R1490871122 CA
Addiction (Substance Use Disorder) Counselor 101YA0400X 14699 CA
Behavior Technician 106S00000X
Case Manager/Care Coordinator 171M00000X
Case Management Agency 251B00000X CA
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X CA Primary

Addresses

Primary practice location

18612 Santa Ana Ave
Bloomington, CA 92316-2636

Mailing address

1302 Rialto Ave
Colton, CA 92324-2433
Phone (909) 835-7482

Other practice location 1

688 N Arrowhead Ave
San Bernardino, CA 92401-1171
Phone (909) 559-4709

Other practice location 2

612 S Myrtle Ave Ste 100
Monrovia, CA 91016-3406
Phone (626) 775-7888

Other practice location 3

2275 E Cooley Dr
Colton, CA 92324-6324
Phone (909) 543-0790 ext. 109

Other practice location 4

930 S Mount Vernon Ave Ste 90
Colton, CA 92324-3928
Phone (909) 660-0097

Other identifiers 2

IdentifierTypeStateIssuer
00051147OtherCACPT 1
14699-IOtherCAREGISTERED ADDICTION COUNSELOR

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

LicenseStateTypeSpecialty
R1490871122CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Masssvcs LLC Behavior Technician CurrentSince Mar 11, 2025 Accepting new patients

Locations

930 S Mount Vernon Ave
Ste 90
Colton, CA 92324
Phone (909) 252-7520

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": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1730655176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 RIALTO AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923242433",
            "telephone_number": "909-835-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18612 SANTA ANA AVE",
            "city": "BLOOMINGTON",
            "state": "CA",
            "postal_code": "923162636",
            "telephone_number": "909-546-8099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "688 N Arrowhead Ave",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924011171",
            "country_code": "US",
            "telephone_number": "909-559-4709",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "612 S Myrtle Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Monrovia",
            "state": "CA",
            "postal_code": "910163406",
            "country_code": "US",
            "telephone_number": "626-775-7888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2275 E Cooley Dr",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923246324",
            "country_code": "US",
            "telephone_number": "909-543-0790 x109",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "930 S Mount Vernon Ave Ste 90",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923243928",
            "country_code": "US",
            "telephone_number": "909-660-0097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUEVARA",
        "first_name": "GLADYS",
        "middle_name": "CECELIA",
        "credential": "CATC III",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-23",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1490871122",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "14699",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CPT 1",
            "identifier": "00051147",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED ADDICTION COUNSELOR",
            "identifier": "14699-I",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.

Verify at the official NPI Registry.