Individual provider Active NPI

Laura Lee Delmont

  • Marriage & Family Therapist
  • Van Nuys, CA
National Provider Identifier
1073644290
Registry record updated Jan 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT40595 Issued in CA
Practice address
6546 Densmore Ave
Van Nuys, CA 91406-6024
Phone
(818) 398-0610
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT40595 CA Primary

Addresses

Primary practice location

6546 Densmore Ave
Van Nuys, CA 91406-6024

Mailing address

6546 Densmore Ave
Van Nuys, CA 91406-6024
Phone (818) 398-0610

Other names 1

  • Laura Lee Wagner Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251007002390 CA Practitioner - Marriage and Family Therapist 2163929167 Practice locations: Lake Balboa, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6546 Densmore Ave
Lake Balboa, CA 91406-6024
Phone (818) 398-0610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFT40595CAMDMarriage & Family Therapist

Interoperability endpoints

  • Direct secure messaging: ldelmont@776.securemail.prognocis.com

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420502400000",
    "number": "1073644290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6546 DENSMORE AVE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914066024",
            "telephone_number": "818-398-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6546 DENSMORE AVE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914066024",
            "telephone_number": "818-398-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELMONT",
        "first_name": "LAURA",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2015-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT40595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "WAGNER",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.