Individual provider Active NPI

Nicole Alexandra Pitesa

  • Marriage & Family Therapist
  • Long Beach, CA
National Provider Identifier
1104240464
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMF85307 Issued in CA
Practice address
5150 E. Pacific Coast Highway
Long Beach, CA 90804-4628
Phone
(562) 981-9392
NPI assigned
Feb 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 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 IMF85307 CA Primary

Addresses

Primary practice location

5150 E. Pacific Coast Highway
Long Beach, CA 90804-4628

Mailing address

5150 E Pacific Coast Hwy
Long Beach, CA 90804-3312
Phone (562) 981-9392

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
IMF85307CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1391644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1104240464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 E PACIFIC COAST HWY",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908043312",
            "telephone_number": "562-981-9392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 E. PACIFIC COAST HIGHWAY",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908044628",
            "telephone_number": "562-981-9392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITESA",
        "first_name": "NICOLE",
        "middle_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-06",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF85307",
            "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 Mar 24, 2015; 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.