Ivonne Thelma Campuzano

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT123631 Issued in CA

Practice address

611 Wilshire Blvd
9TH Floor, Unit #574
Los Angeles, CA 90017

Phone

(213) 955-7250

NPI assigned

Oct 22, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846
  Medicare reassignment NPD
• Cyti Health PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Diego, CA
  • NPI 1679172290
  Medicare reassignment

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1043786502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 WILSHIRE BLVD 9TH FL",
            "address_2": "UNIT #574",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174025",
            "telephone_number": "213-955-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 WILSHIRE BLVD",
            "address_2": "9TH FLOOR, UNIT #574",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90017",
            "telephone_number": "213-955-7250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2750 E Washington Blvd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911071449",
            "country_code": "US",
            "telephone_number": "626-296-8900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "66 Hurlbut St",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911054025",
            "country_code": "US",
            "telephone_number": "626-441-4221",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "66 Hurlbut St",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911054025",
            "country_code": "US",
            "telephone_number": "626-441-4221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPUZANO",
        "first_name": "IVONNE",
        "middle_name": "THELMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-22",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "AMFT109225",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT109225",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT123631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karina Ashley Camposagrado, M.S., CF-SLP
• Zuleika Camposano
• Jennifer Leigh Campoy, LCSW
• Garrett Alejandro Camps, MD
• Blanca Campuzano
• Jocelyn Sarhay Campuzano
• Maricella Campuzano
• Tatiana Campuzano, MD
• Rashida Taher Campwala, M.D.
• Erin Camron, N.P.

• Marriage & Family Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.