Individual provider Active NPI

Chanel Renee Higgs

  • Marriage & Family Therapist
  • Long Beach, CA
National Provider Identifier
1083900690
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
138414 Issued in CA
Practice address
5190 Atlantic Ave
Long Beach, CA 90805-6510
Phone
(562) 428-4111
NPI assigned
Jun 22, 2011
Last updated
Mar 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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 138414 CA Primary

Addresses

Primary practice location

5190 Atlantic Ave
Long Beach, CA 90805-6510

Mailing address

5190 Atlantic Ave
Long Beach, CA 90805-6510
Phone (562) 428-4111

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
I20231129003674 CA Practitioner - Marriage and Family Therapist 1658729728 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
138414CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tarzana Treatment Centers, Inc. Current Accepting new patients
Tarzana Treatment Centers, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Tarzana Treatment Centers, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Haynes Family of Programs PastSince Apr 1, 2020 Accepting new patients

Locations

5190 Atlantic Ave
Long Beach, CA 90805
Phone (562) 428-4111

18646 Oxnard St
Tarzana, CA 91356
Phone (818) 654-3815

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1083900690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5190 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908056510",
            "telephone_number": "562-428-4111",
            "fax_number": "562-984-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5190 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908056510",
            "telephone_number": "562-428-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGGS",
        "first_name": "CHANEL",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "138414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.