Benjamin Read Campos, LMFT 122553

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

122553 Issued in CA

Practice address

2178 Johnson Ave
San Luis Obispo, CA 93401-4535

Phone

(805) 461-6042

NPI assigned

Aug 5, 2008

Reactivated

Mar 12, 2012

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• All for Kids Organization

  • Community/Behavioral Health Agency
  • Los Angeles, CA
  • NPI 1174659957
  NPD (past)

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1144486408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2178 JOHNSON AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014535",
            "telephone_number": "805-461-6042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2178 JOHNSON AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014535",
            "telephone_number": "805-461-6042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3910 Oakwood Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900043413",
            "country_code": "US",
            "telephone_number": "323-953-7350 x419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPOS",
        "first_name": "BENJAMIN",
        "middle_name": "READ",
        "credential": "LMFT 122553",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-05",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "deactivation_date": "2010-09-21",
        "reactivation_date": "2012-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "IMFT 84420",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "122553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144486408",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Evelyn Campbell
• Kyle Campbell
• Larry James Campbell, LMFT
• Tyler P Campbell, MD
• Melissa Carol Campe, M.S.
• Catuih Campos
• Leticia J Campos
• Monique Marie Campos
• Holly Campuzano
• Marina Canella

• Marriage & Family Therapist in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.