Individual provider Active NPI

Evangeline Deomampo Leon-Torres, MPH, CHES

  • Specialist
  • San Diego, CA
National Provider Identifier
1982723706
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
CHES#5648 Issued in HI
Practice address
3851 Rosecrans St
San Diego, CA 92110-3115
Phone
(619) 692-8023
Fax
(619) 692-8827
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X CHES#5648 HI Primary

Addresses

Primary practice location

3851 Rosecrans St
San Diego, CA 92110-3115

Mailing address

1729 Valley Bend St
Chula Vista, CA 91913-1766
Phone (619) 656-0528

Other names 1

  • Evangeline Montero Deomampo Former name

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
CHES#5648HIMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982723706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 VALLEY BEND ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919131766",
            "telephone_number": "619-656-0528",
            "fax_number": "619-656-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 ROSECRANS ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103115",
            "telephone_number": "619-692-8023",
            "fax_number": "619-692-8827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON-TORRES",
        "first_name": "EVANGELINE",
        "middle_name": "DEOMAMPO",
        "credential": "MPH, CHES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "HI",
            "license": "CHES#5648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVANGELINE",
            "last_name": "DEOMAMPO",
            "middle_name": "MONTERO",
            "credential": "MPH, CHES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.