Individual provider Active NPI

Beverly Amaral

  • Marriage & Family Therapist
  • La Verne, CA
National Provider Identifier
1023589124
Registry record updated Dec 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
109639 Issued in CA
Practice address
233 Baseline Rd
La Verne, CA 91750-2353
Phone
(909) 833-2986
NPI assigned
Dec 16, 2018
Last updated
Dec 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 109639 CA Primary

Addresses

Primary practice location

233 Baseline Rd
La Verne, CA 91750-2353

Mailing address

233 Baseline Rd
La Verne, CA 91750-2353
Phone (909) 833-2986

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
I20260520003803 CA Practitioner - Marriage and Family Therapist 3274002092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

402 W Broadway
Suite 400
San Diego, CA 92101-3554

618 E Van Koevering St
Rialto, CA 92376-5238

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1023589124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 BASELINE RD",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502353",
            "telephone_number": "909-833-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 BASELINE RD",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502353",
            "telephone_number": "909-833-2986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMARAL",
        "first_name": "BEVERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "109639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Verne, CA

Sources for this page

Verify at the official NPI Registry.