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GLORIA AGUILAR BLANCEAGLE PSY.D.
NPI 1639600901
Psychologist - Clinical in Santa Cruz, CA

Active since March 27, 2017PECOS EnrolledAccepts Medicare Assignment
708 NOBEL DR UNIT C, SANTA CRUZ, CA 95060(831) 459-1818 Get Directions Write a Review

NPPES record last updated: March 27, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Gloria Aguilar Blanceagle Psy.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GLORIA AGUILAR BLANCEAGLE PSY.D. (NPI 1639600901) is an individual clinical provider in Santa Cruz, California, licensed in California (28250) and active in the NPI registry since March 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1639600901
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameGLORIA AGUILAR BLANCEAGLECredential: PSY.D.
Location Address708 NOBEL DR UNIT CSanta Cruz, CA 95060-2366
Mailing Address708 Nobel Dr Unit CSanta Cruz, CA 95060-2366 · (831) 459-1818
Phone(831) 459-1818
Sole ProprietorYes
Medical School CMSOtherGraduated 2006
Enumeration DateMarch 27, 2017
✔ NPI 1639600901 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · 28250
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
708 NOBEL DR UNIT C, Santa Cruz, CA 95060
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gloria Aguilar Blanceagle Psy.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9830605195
PECOS Enrollment IDI20250723001055
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Gloria Blanceagle reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mendocino Coast Clinics, Inc.
194 mi
Federally Qualified Health Center (FQHC)
510 CYPRESS ST STE C-100
Fort Bragg, CA 95437
  • Reassigned Medicare billing, California enrollment
  • 33 clinicians in this Medicare group
NPI 1285128595 (707) 961-3430

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95060 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$186.69 typical visit price
range $62.97 – $186.69
Typical copayment $46.67 (range $15.74 – $46.67)
Most-billed visit code 99205
Established Patient
$109.72 typical visit price
range $21.02 – $153.16
Typical copayment $27.43 (range $5.25 – $38.29)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gloria Blanceagle's NPI number?

The NPI number for Gloria Blanceagle is 1639600901. It was assigned to this individual provider in the NPPES registry on March 27, 2017.

Where is Gloria Blanceagle located?

Gloria Blanceagle practices at 708 Nobel Dr Unit C, Santa Cruz, CA 95060. The listed phone number is (831) 459-1818.

What is Gloria Blanceagle's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Gloria Blanceagle enrolled in Medicare?

Yes. Gloria Blanceagle is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Gloria Blanceagle's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gloria Blanceagle reassigns Medicare benefits to Mendocino Coast Clinics, Inc. (Fort Bragg, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gloria Blanceagle's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Gloria Blanceagle was last updated on March 27, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.