Active NPI
Celena Derderian Pentagulio
- Psychiatry Physician
- Ventura, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A178633
- Practice address
- 300 Hillmont Ave
Ventura, CA 93003-1651 - Phone
- (805) 652-6000
- NPI assigned
- Mar 27, 2020
- Last updated
- Oct 15, 2025
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | A178633 | CA | Primary |
Addresses
Primary practice location
300 Hillmont Ave
Ventura, CA 93003-1651
Mailing address
1200 N State Street Clinic Tower
Suite A7D
Los Angeles, CA 90033-1029
Phone (323) 409-5555
Other practice location 1
1200 N State Street Clinic Tower
Suite A7D
Los Angeles, CA 90033-1029
Phone (323) 409-5555
Other practice location 2
200 Hillmont Ave
Ventura, CA 93003-1647
Phone (805) 652-6729
Other names 1
- Celena Joyce Derderian
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | celena.pentaguilio@ventura.cernerdirect.com | Direct | |
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Creighton University School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1294 W 6TH St
FL 2
San Pedro, CA 90731-2987
Phone (310) 519-6100
2512 Artesia Blvd
Suite 320
Redondo Beach, CA 90278-3282
Phone (424) 277-2899
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A178633 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regeneration Psychiatry | Psychiatry | Current | Accepting new patients |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Rebecca Salamo MD Inc | Psychiatry | Current | Accepting new patients |
| County of Ventura | Current | Accepting new patients | |
| Los Angeles County Department of Mental Health | Current | Accepting new patients | |
| County of Ventura | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Los Angeles County Department of Mental Health | Current | Accepting new patients | |
| County of Ventura | Current | Accepting new patients |
Locations
43112 15th St W
Lancaster, CA 93534
Phone (661) 726-2222
510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416
13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417
393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235
2512 Artesia Blvd
Ste 310
Redondo Beach, CA 90278
Phone (310) 323-6767
2512 Artesia Blvd
Ste 320
Redondo Beach, CA 90278
Phone (424) 277-2899
1294 W 6th St
Fl 2
San Pedro, CA 90731
Phone (310) 519-6100
200 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-5755
300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000
800 S Victoria Ave
#L4640
Ventura, CA 93009
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- celena.pentaguilio@ventura.cernerdirect.com
- celena.pentagulio.1@24050.direct.athenahealth.com
- https://api.platform.athenahealth.com/24050/brand/1/csg/1/fhir/r4
Organizations & group practices 11
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychiatry Physician
- Redondo Beach, CA
- NPI 1285200584
-
dba GENESIS Countywide Older Adult Program
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Los Angeles, CA
- NPI 1083633929
-
dba Ventura County Medical Center
- General Acute Care Hospital
- Ventura, CA
- NPI 1629167457
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
dba VCBH - Simi Valley Youth & Family Mental Health
- Community/Behavioral Health Agency
- Simi Valley, CA
- NPI 1609098243
-
dba VCBH - North Oxnard Youth & Family Mental Health
- Community/Behavioral Health Agency
- Oxnard, CA
- NPI 1912690769
-
dba San Pedro Mental Health Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- San Pedro, CA
- NPI 1629001037
-
dba Arcadia Mental Health Center-Full Service Partnership
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Arcadia, CA
- NPI 1902676075
-
- Psychiatry Physician
- Redondo Beach, CA
- NPI 1467283614
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Panorama City, CA
- NPI 1407888928
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760486400000",
"number": "1790312783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 N STATE STREET CLINIC TOWER",
"address_2": "SUITE A7D",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331029",
"telephone_number": "323-409-5555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 HILLMONT AVE",
"city": "VENTURA",
"state": "CA",
"postal_code": "930031651",
"telephone_number": "805-652-6000"
}
],
"practiceLocations": [
{
"address_1": "1200 N State Street Clinic Tower",
"address_2": "Suite A7D",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900331029",
"country_code": "US",
"telephone_number": "323-409-5555",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "200 Hillmont Ave",
"address_purpose": "LOCATION",
"city": "Ventura",
"state": "CA",
"postal_code": "930031647",
"country_code": "US",
"telephone_number": "805-652-6729",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PENTAGULIO",
"first_name": "CELENA",
"middle_name": "DERDERIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-27",
"last_updated": "2025-10-15",
"certification_date": "2025-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A178633",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "celena.pentaguilio@ventura.cernerdirect.com",
"affiliation": "N",
"endpointDescription": "Cerner Direct Secure Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct Information",
"address_1": "300 Hillmont Ave",
"city": "Ventura",
"state": "CA",
"country_code": "US",
"postal_code": "930031651",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "43112 15th St W",
"city": "Lancaster",
"state": "CA",
"country_code": "US",
"postal_code": "935346219",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "CELENA",
"last_name": "DERDERIAN",
"middle_name": "JOYCE",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Ventura, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.