Individual provider Active NPI

Theresa A Pasqualino, M.A.

  • Case Manager/Care Coordinator
  • Lake View Terrace, CA
National Provider Identifier
1144745134
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
11600 Eldridge Ave
Lake View Terrace, CA 91342-6506
Phone
(818) 686-3022
NPI assigned
Aug 10, 2017
Sex
Female
Sole proprietor
No

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
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

11600 Eldridge Ave
Lake View Terrace, CA 91342-6506

Mailing address

11600 Eldridge Ave
Lake View Terrace, CA 91342-6506
Phone (818) 686-3022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241007001498 CA Practitioner - Marriage and Family Therapist 0244761880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Change Within Reach IncGroup PAC ID 2062723810, 13 clinicians

Practice addresses (Care Compare)

17777 Ventura Blvd
Suite 105
Encino, CA 91316-3738
Phone (213) 908-1234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Change Within Reach Inc CurrentSince Sep 25, 2024 Accepting new patients

Locations

17777 Ventura Blvd
Ste 105
Encino, CA 91316
Phone (213) 445-2266

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1502323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1144745134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11600 ELDRIDGE AVE",
            "city": "LAKE VIEW TERRACE",
            "state": "CA",
            "postal_code": "913426506",
            "telephone_number": "818-686-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 ELDRIDGE AVE",
            "city": "LAKE VIEW TERRACE",
            "state": "CA",
            "postal_code": "913426506",
            "telephone_number": "818-686-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASQUALINO",
        "first_name": "THERESA",
        "middle_name": "A",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake View Terrace, CA

Sources for this page

Verify at the official NPI Registry.