Individual provider Active NPI

Chin Lan Tao, MFT

  • Marriage & Family Therapist
  • Ventura, CA
National Provider Identifier
1124147400
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT42106 Issued in CA
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

Updated by the provider on Jul 21, 2022

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 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

IdentifierTypeStateIssuer
00007473MedicaidCA
CCBSC866OtherCALA 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

LicenseStateTypeSpecialty
MFT42106CAMDMarriage & 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.

Verify at the official NPI Registry.