Individual provider Active NPI

Nidia M Moran Canales

  • Marriage & Family Therapist
  • Long Beach, CA
National Provider Identifier
1063719235
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT51634 Issued in CA
Practice address
555 E Ocean Blvd Ste 330
Long Beach, CA 90802-5052
Phone
(562) 542-1144
Fax
(951) 346-5511
NPI assigned
Feb 23, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X LMFT51634 CA Primary

Addresses

Primary practice location

555 E Ocean Blvd Ste 330
Long Beach, CA 90802-5052

Mailing address

555 E Ocean Blvd Ste 330
Long Beach, CA 90802-5052
Phone (562) 542-1144

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

State licenses

LicenseStateTypeSpecialty
LMFT51634CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1298419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1063719235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E OCEAN BLVD STE 330",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908025052",
            "telephone_number": "562-542-1144",
            "fax_number": "951-346-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E OCEAN BLVD STE 330",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908025052",
            "telephone_number": "562-542-1144",
            "fax_number": "951-346-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN CANALES",
        "first_name": "NIDIA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-23",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT51634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.