Individual provider Active NPI

Aldo Ulises Sarellano, MS, LMFT

  • Marriage & Family Therapist
  • Culver City, CA
National Provider Identifier
1164784484
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
116660 Issued in CA
Practice address
3831 Hughes Ave Ste 509
Culver City, CA 90232-6861
Phone
(925) 282-1778
NPI assigned
Jun 12, 2012
Last updated
Oct 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X
Marriage & Family Therapist 106H00000X 116660 CA Primary

Addresses

Primary practice location

3831 Hughes Ave Ste 509
Culver City, CA 90232-6861

Mailing address

3831 Hughes Ave Ste 509
Culver City, CA 90232-6861

Other practice location 1

191 S Buena Vista St Ste 300
Burbank, CA 91505-4556
Phone (925) 282-1778

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
I20241024003528 CA Practitioner - Marriage and Family Therapist 8820521123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

3831 Hughes Ave
Suite 509
Culver City, CA 90232-6861
Phone (925) 282-1778

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
116660CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc CurrentSince Sep 21, 2024 Accepting new patients

Locations

191 S Buena Vista St
Ste 300
Burbank, CA 91505
Phone (818) 846-8981

3831 Hughes Ave
Ste 509
Culver City, CA 90232
Phone (310) 559-4833

6200 Wilshire Blvd
Ste 1410
Los Angeles, CA 90048
Phone (323) 434-0011

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.aldosarellano@148377.advancedmd-direct.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1164784484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3831 HUGHES AVE STE 509",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902326861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3831 HUGHES AVE STE 509",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902326861",
            "telephone_number": "925-282-1778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "191 S Buena Vista St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Burbank",
            "state": "CA",
            "postal_code": "915054556",
            "country_code": "US",
            "telephone_number": "925-282-1778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SARELLANO",
        "first_name": "ALDO",
        "middle_name": "ULISES",
        "credential": "MS, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-12",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "116660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.