Active NPI
Mike Faiola
- Marriage & Family Therapist
- San Pedro, CA
National Provider Identifier
1124910203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- AMFT147340
- Practice address
- 302 W 5TH St
San Pedro, CA 90731-2738 - Phone
- (424) 570-6995
- NPI assigned
- Jul 15, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
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 | AMFT147340 | CA | Primary |
Addresses
Primary practice location
302 W 5TH St
San Pedro, CA 90731-2738
Mailing address
313 17TH PL
Manhattan Beach, CA 90266-4643
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 |
|---|---|---|---|
| AMFT147340 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1752537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752537600000",
"number": "1124910203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "313 17TH PL",
"city": "MANHATTAN BEACH",
"state": "CA",
"postal_code": "902664643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 W 5TH ST",
"city": "SAN PEDRO",
"state": "CA",
"postal_code": "907312738",
"telephone_number": "424-570-6995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIOLA",
"first_name": "MIKE",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2025-07-15",
"last_updated": "2025-07-15",
"certification_date": "2025-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "AMFT147340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Pedro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.