Individual provider Active NPI

John David Miyabe, MFT

  • Marriage & Family Therapist
  • Torrance, CA
National Provider Identifier
1114058823
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT 9430 Issued in CA
Practice address
370 Crenshaw Blvd
Torrance, CA 90503-1727
Phone
(310) 787-1500
Fax
(310) 787-8045
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MFT 9430 CA Primary

Addresses

Primary practice location

370 Crenshaw Blvd
Torrance, CA 90503-1727

Mailing address

5829 Ocean Terrace Dr
Rancho Palos Verdes, CA 90275-5758
Phone (310) 803-0448

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
MFT 9430CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114058823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5829 OCEAN TERRACE DR",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902755758",
            "telephone_number": "310-803-0448",
            "fax_number": "310-541-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 CRENSHAW BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905031727",
            "telephone_number": "310-787-1500",
            "fax_number": "310-787-8045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIYABE",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT 9430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.