Active NPI
Andrew Theodore Ezpeleta, ACSW
- Mental Health Counselor
- Mission Viejo, CA
National Provider Identifier
1881178952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 84637
- Practice address
- 27261 Las Ramblas Ste 220
Mission Viejo, CA 92691-6468 - Phone
- (714) 966-8650
- NPI assigned
- Sep 24, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 84637 | CA | Primary |
Addresses
Primary practice location
27261 Las Ramblas Ste 220
Mission Viejo, CA 92691-6468
Mailing address
PO Box 676
Loma Linda, CA 92354-0676
Phone (360) 213-5907
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 |
|---|---|---|---|
| 84637 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537747200000",
"number": "1881178952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 676",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923540676",
"telephone_number": "360-213-5907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27261 LAS RAMBLAS STE 220",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926916468",
"telephone_number": "714-966-8650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZPELETA",
"first_name": "ANDREW",
"middle_name": "THEODORE",
"credential": "ACSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-09-24",
"last_updated": "2018-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "84637",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mission Viejo, CA
- Veronica Estrada, FNP
- Edmund S Evangelista, MD
- Sherri Evans
- Everwell Recovery LLC
- Eyedeology Optometry of Mission Viejo (Eyedeology Optometry)
- F Awadalla MD PC (Skincredible Dermatology & Surgery)
- F Awadalla MD PC (Skincredible Dermatology & Surgery)
- F Lee Irwin Jr MD Inc
- Faculty Physicians and Surgeons of Llusm
- Roushanak Fadavi, O.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.