Individual provider Active NPI

Concepcion R Mangasep, M. D.

  • Psychiatry Physician
  • Buena Park, CA
National Provider Identifier
1861441701
Registry record updated Jul 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A66574 Issued in CA
Practice address
7661 Puerto Rico Dr
Buena Park, CA 90620-1270
Phone
(213) 422-2920
Fax
(818) 670-7892
NPI assigned
May 8, 2006
Last updated
Jul 22, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A66574 CA Primary

Addresses

Primary practice location

7661 Puerto Rico Dr
Buena Park, CA 90620-1270

Mailing address

7661 Puerto Rico Dr
Buena Park, CA 90620-1270
Phone (213) 422-2920

Other identifiers 2

IdentifierTypeStateIssuer
123853OtherCALACO MENTAL HEALTH
00A665740MedicaidCA

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
I20050404000988 CA Practitioner - Psychiatry 0345297131 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1988
Medicare assignment
May accept Medicare assignment
Group practices
County of RiversideGroup PAC ID 6507754488, 190 clinicians

Practice addresses (Care Compare)

2776 Pacific Ave
Long Beach, CA 90806-2613
Phone (562) 997-2000

3630 E Imperial Hwy
Lynwood, CA 90262-2609
Phone (310) 900-8900

9990 County Farm Rd
Suite 2
Riverside, CA 92503-3542
Phone (951) 358-4700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A66574CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Concepcion Mangasep M.D., Inc. Psychiatry CurrentSince Jun 11, 2007 Accepting new patients
County of Riverside Current Accepting new patients
County of Riverside CurrentSince Jul 20, 2017 Accepting new patients
Health Service Alliance CurrentSince Jan 1, 2025 Accepting new patients
Health Service Alliance CurrentSince Jan 1, 2025 Accepting new patients
County of Riverside CurrentSince Jul 20, 2017 Accepting new patients
Foothills Psychological Services, Inc. Psychiatry PastSince Jan 1, 2006 Accepting new patients

Locations

13193 Central Ave
Ste 100
Chino, CA 91710
Phone (909) 464-9675

13193 Central Ave
Ste 200
Chino, CA 91710
Phone (909) 902-9111

16377 Main St
Ste A
Hesperia, CA 92345
Phone (760) 688-4808

3630 E Imperial Hwy
Lynwood, CA 90262
Phone (310) 900-7420

4651 Holt Blvd
Ste G
Montclair, CA 91763
Phone (909) 326-0414

5050 San Bernardino St
Montclair, CA 91763
Phone (909) 281-5800

10837 Laurel St
Ste 204
Rancho Cucamonga, CA 91730
Phone (310) 246-0702

9089 Base Line Rd
Ste 200
Rch Cucamonga, CA 91730
Phone (909) 480-3567

9990 County Farm Rd
Ste 2
Riverside, CA 92503
Phone (951) 358-4790

600 N Euclid Ave
Ste 204
Upland, CA 91786
Phone (909) 379-1513

Interoperability endpoints

  • Direct secure messaging: cmangasep100992@direct.llu.edu

Organizations & group practices 8

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216684800000",
    "number": "1861441701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7661 PUERTO RICO DR",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906201270",
            "telephone_number": "213-422-2920",
            "fax_number": "818-670-7892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7661 PUERTO RICO DR",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906201270",
            "telephone_number": "213-422-2920",
            "fax_number": "818-670-7892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGASEP",
        "first_name": "CONCEPCION",
        "middle_name": "R",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2008-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A66574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LACO MENTAL HEALTH",
            "identifier": "123853",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A665740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buena Park, CA

Sources for this page

Verify at the official NPI Registry.