Individual provider Active NPI

Diane Simon Smith, MFT

  • Marriage & Family Therapist
  • Woodland Hills, CA
National Provider Identifier
1124146162
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC34070 Issued in CA
Practice address
20750 Ventura Blvd
Suite 245
Woodland Hills, CA 91364-2338
Phone
(818) 888-1524
Fax
(818) 348-1364
NPI assigned
Mar 27, 2007
Sex
Female
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 MFC34070 CA Primary

Addresses

Primary practice location

20750 Ventura Blvd
Suite 245
Woodland Hills, CA 91364-2338

Mailing address

20750 Ventura Blvd
Suite 245
Woodland Hills, CA 91364-2338
Phone (818) 888-1524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 22, 2024 through Jan 22, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC34070CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124146162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20750 VENTURA BLVD",
            "address_2": "SUITE 245",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913642338",
            "telephone_number": "818-888-1524",
            "fax_number": "818-348-1364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20750 VENTURA BLVD",
            "address_2": "SUITE 245",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913642338",
            "telephone_number": "818-888-1524",
            "fax_number": "818-348-1364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DIANE",
        "middle_name": "SIMON",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC34070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

Verify at the official NPI Registry.