Healthcare Provider Details

I. General information

NPI: 1427557396
Provider Name (Legal Business Name): VIRGINIA CAPELLO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VIRGINIA MOON-PANAGIOTES

II. Dates (important events)

Enumeration Date: 02/06/2018
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 BLOOMWOOD CT
HEMET CA
92545-8041
US

IV. Provider business mailing address

PO BOX 2123
HOMELAND CA
92548-2123
US

V. Phone/Fax

Practice location:
  • Phone: 951-254-2313
  • Fax:
Mailing address:
  • Phone: 949-922-0712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number106363
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: