Active NPI
Gladdiss Infante
- Marriage & Family Therapist
- Long Beach, CA
National Provider Identifier
1063908424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 144467
- Practice address
- 1301 Pine Ave
Long Beach, CA 90813-3124 - Phone
- (562) 595-1159
- NPI assigned
- Jul 9, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Marriage & Family Therapist | 106H00000X | 144467 | CA | Primary |
| Rehabilitation Practitioner | 225400000X |
Addresses
Primary practice location
1301 Pine Ave
Long Beach, CA 90813-3124
Mailing address
1301 Pine Ave
Long Beach, CA 90813-3124
Phone (562) 595-1159
Other practice location 1
9808 Venice Blvd Ste 700
Culver City, CA 90232-6824
Phone (310) 945-3350
Other practice location 2
1721 Griffin Ave
Los Angeles, CA 90031-3312
Phone (323) 221-4134
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
| License | State | Type | Specialty |
|---|---|---|---|
| 144467 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707868800000",
"number": "1063908424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 PINE AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908133124",
"telephone_number": "562-595-1159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 PINE AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908133124",
"telephone_number": "562-595-1159"
}
],
"practiceLocations": [
{
"address_1": "9808 Venice Blvd Ste 700",
"address_purpose": "LOCATION",
"city": "Culver City",
"state": "CA",
"postal_code": "902326824",
"country_code": "US",
"telephone_number": "310-945-3350",
"fax_number": "310-945-3356",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1721 Griffin Ave",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900313312",
"country_code": "US",
"telephone_number": "323-221-4134",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "INFANTE",
"first_name": "GLADDISS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-09",
"last_updated": "2024-02-14",
"certification_date": "2024-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "144467",
"primary": true
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"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 Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.