Active NPI
Michelle Annqunet Porter
- Mental Health Counselor
- Carson, CA
National Provider Identifier
1083800577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 320 E Centerview Dr
Carson, CA 90746-1134 - Phone
- (310) 324-0515
- NPI assigned
- Sep 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
320 E Centerview Dr
Carson, CA 90746-1134
Mailing address
320 E Centerview Dr
Carson, CA 90746-1134
Phone (310) 324-0515
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12901261604 | Other | CA | 12901261604 |
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": "1190160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190160000000",
"number": "1083800577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 E CENTERVIEW DR",
"city": "CARSON",
"state": "CA",
"postal_code": "907461134",
"telephone_number": "310-324-0515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 E CENTERVIEW DR",
"city": "CARSON",
"state": "CA",
"postal_code": "907461134",
"telephone_number": "310-324-0515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "MICHELLE",
"middle_name": "ANNQUNET",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-19",
"last_updated": "2007-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "12901261604",
"identifier": "12901261604",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carson, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.