Individual provider Active NPI

Stephanie Ariana Acevedo-Moran, LMFT, LAADC,BCBA

  • Marriage & Family Therapist
  • Los Alamitos, CA
National Provider Identifier
1013330620
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
98990 Issued in CA
Practice address
5212 Katella Ave Ste 103B
Los Alamitos, CA 90720-6828
Phone
(714) 743-0704
NPI assigned
Feb 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LR05740121 CA
Behavior Analyst 103K00000X 1-14-10236 CA
Marriage & Family Therapist 106H00000X 98990 CA Primary

Addresses

Primary practice location

5212 Katella Ave Ste 103B
Los Alamitos, CA 90720-6828

Mailing address

10332 Florence Ave
Buena Park, CA 90620-4425
Phone (714) 743-0704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240522003716 CA Practitioner - Marriage and Family Therapist 0941642995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LR05740121CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Glenn Medical Center, LLC PastSince Apr 10, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1391385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1013330620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10332 FLORENCE AVE",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906204425",
            "telephone_number": "714-743-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5212 KATELLA AVE STE 103B",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907206828",
            "telephone_number": "714-743-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACEVEDO-MORAN",
        "first_name": "STEPHANIE",
        "middle_name": "ARIANA",
        "name_prefix": "Miss",
        "credential": "LMFT, LAADC,BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-03",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "LR05740121",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-14-10236",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "98990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

Verify at the official NPI Registry.