Healthcare Provider Details

I. General information

NPI: 1063110377
Provider Name (Legal Business Name): EVELYN OREGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2023
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 E ARROW HWY
POMONA CA
91767-2535
US

IV. Provider business mailing address

180 VIA VERDE STE 200
SAN DIMAS CA
91773-3993
US

V. Phone/Fax

Practice location:
  • Phone: 909-624-1233
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number136554
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: