Individual provider Active NPI

Annielynn Dayao Ibale

  • Mental Health Counselor
  • La Puente, CA
National Provider Identifier
1053601799
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
36359 Issued in CA
Practice address
160 S 7TH Ave
La Puente, CA 91746-3211
Phone
(626) 961-8971
NPI assigned
Apr 14, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 36359 CA Primary
Rehabilitation Practitioner 225400000X

Addresses

Primary practice location

160 S 7TH Ave
La Puente, CA 91746-3211

Mailing address

160 S 7TH Ave
La Puente, CA 91746-3211
Phone (626) 961-8971

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

NPI Registry JSON

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1053601799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 S 7TH AVE",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917463211",
            "telephone_number": "626-961-8971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 S 7TH AVE",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917463211",
            "telephone_number": "626-961-8971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBALE",
        "first_name": "ANNIELYNN",
        "middle_name": "DAYAO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-14",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "36359",
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Puente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.