Individual provider Active NPI

Roberta Lester, MFT

  • Marriage & Family Therapist
  • Redondo Beach, CA
National Provider Identifier
1104846500
Registry record updated Apr 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
M13384 Issued in CA
Practice address
1617 S Pacific Coast Hwy
Suite H
Redondo Beach, CA 90277-5612
Phone
(310) 944-9292
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2009

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 M13384 CA Primary

Addresses

Primary practice location

1617 S Pacific Coast Hwy
Suite H
Redondo Beach, CA 90277-5612

Mailing address

1617 S Pacific Coast Hwy
Suite H
Redondo Beach, CA 90277-5612
Phone (310) 944-9292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 3, 2024 through Jun 3, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
M13384CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238630400000",
    "number": "1104846500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 S PACIFIC COAST HWY",
            "address_2": "SUITE H",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775612",
            "telephone_number": "310-944-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 S PACIFIC COAST HWY",
            "address_2": "SUITE H",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775612",
            "telephone_number": "310-944-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESTER",
        "first_name": "ROBERTA",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2009-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "M13384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

Verify at the official NPI Registry.