Active NPI
Mallory Lorraine Molle, M.S.
- Marriage & Family Therapist
- San Pedro, CA
National Provider Identifier
1043628555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 97620
- Practice address
- 555 W 9TH St Ste 5
San Pedro, CA 90731-3157 - Phone
- (424) 287-7567
- NPI assigned
- Jul 28, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 97620 | CA | Primary |
Addresses
Primary practice location
555 W 9TH St Ste 5
San Pedro, CA 90731-3157
Mailing address
PO Box 6521
San Pedro, CA 90734-6521
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 97620 | CA | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| College Community Services | Past | Accepting new patients | |
| College Community Services | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Westminster, CA
- NPI 1144578816
-
- Community/Behavioral Health Agency
- Santa Ana, CA
- NPI 1528197662
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664150400000",
"number": "1043628555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6521",
"city": "SAN PEDRO",
"state": "CA",
"postal_code": "907346521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 W 9TH ST STE 5",
"city": "SAN PEDRO",
"state": "CA",
"postal_code": "907313157",
"telephone_number": "424-287-7567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLLE",
"first_name": "MALLORY",
"middle_name": "LORRAINE",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-28",
"last_updated": "2022-09-26",
"certification_date": "2022-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "97620",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Pedro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.