Active NPI
Chin Lan Tao, MFT
- Marriage & Family Therapist
- Ventura, CA
National Provider Identifier
1124147400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT42106
- Practice address
- 644 E Thompson Blvd
Ventura, CA 93001-2829 - Phone
- (805) 201-5159
- Fax
- (805) 652-0745
- NPI assigned
- Mar 28, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFT42106 | CA | Primary |
Addresses
Primary practice location
644 E Thompson Blvd
Ventura, CA 93001-2829
Mailing address
644 E Thompson Blvd
Ventura, CA 93001-2829
Phone (805) 201-5159
Other practice location 1
921 W Avenue J Ste C
Lancaster, CA 93534-3443
Phone (661) 949-0131 ext. 143
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00007473 | Medicaid | CA | |
| CCBSC866 | Other | CA | LA DMH PROVIDER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MFT42106 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1124147400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "644 E THOMPSON BLVD",
"city": "VENTURA",
"state": "CA",
"postal_code": "930012829",
"telephone_number": "805-201-5159",
"fax_number": "805-652-0745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "644 E THOMPSON BLVD",
"city": "VENTURA",
"state": "CA",
"postal_code": "930012829",
"telephone_number": "805-201-5159",
"fax_number": "805-652-0745"
}
],
"practiceLocations": [
{
"address_1": "921 W Avenue J Ste C",
"address_purpose": "LOCATION",
"city": "Lancaster",
"state": "CA",
"postal_code": "935343443",
"country_code": "US",
"telephone_number": "661-949-0131 x143",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TAO",
"first_name": "CHIN",
"middle_name": "LAN",
"name_prefix": "Ms.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-28",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFT42106",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00007473",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LA DMH PROVIDER",
"identifier": "CCBSC866",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ventura, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.