Individual provider Active NPI

Evita Marie Rocha, M.D.

  • Psychiatry Physician
  • Riverside, CA
National Provider Identifier
1801230891
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A138937 Issued in CA
Practice address
5225 Canyon Crest Dr
Riverside, CA 92507-6301
Phone
(909) 856-8791
NPI assigned
Apr 22, 2013
Last updated
Dec 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A138937 CA Primary
Child & Adolescent Psychiatry Physician 2084P0804X A138937 CA

Addresses

Primary practice location

5225 Canyon Crest Dr
Riverside, CA 92507-6301

Mailing address

7060 Clairemont Mesa Blvd
San Diego, CA 92111-1003

Other practice location 1

7060 Clairemont Mesa Blvd
San Diego, CA 92111-1003
Phone (858) 573-6400

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190923001252 CA Practitioner - Psychiatry 8628375136 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A138937CAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Aug 5, 2019 Accepting new patients
Southern California Permanente Medical Group Single Specialty CurrentSince Aug 5, 2019 Accepting new patients

Locations

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

5225 Canyon Crest Dr
Riverside, CA 92507
Phone (951) 244-4147

7060 Clairemont Mesa Blvd
San Diego, CA 92111
Phone (858) 573-6400

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1801230891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7060 CLAIREMONT MESA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 CANYON CREST DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925076301",
            "telephone_number": "909-856-8791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7060 Clairemont Mesa Blvd",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921111003",
            "country_code": "US",
            "telephone_number": "858-573-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROCHA",
        "first_name": "EVITA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-22",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A138937",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A138937",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "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": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.