Laura G.T. Nguyen Russo, LMFT102780

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT102780 Issued in CA

Practice address

12816 Inglewood Ave # 73
Hawthorne, CA 90250-5118

Phone

(949) 229-0148

NPI assigned

Dec 19, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Lotus Licensed Marriage and Family Therapy, Inc

  • Marriage & Family Therapist
  • Hawthorne, CA
  • NPI 1912615352
  NPD Authorized official

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

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1174869127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12816 INGLEWOOD AVE # 73",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902505118",
            "telephone_number": "949-229-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12816 INGLEWOOD AVE # 73",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902505118",
            "telephone_number": "949-229-0148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5150 E Pacific Coast Hwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908043394",
            "country_code": "US",
            "telephone_number": "562-498-5252 x252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN RUSSO",
        "first_name": "LAURA",
        "middle_name": "G.T.",
        "credential": "LMFT102780",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-19",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF76963",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT102780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Hope Medical Supply
• Shauna Newman
• Anne Tiba Nganga
• Melanie Ngov
• Nguyen Dental Inc
• Dat Q Nguyen, MD
• Lieu Nguyen, M.D.
• Nicole Nguyen
• Patrisia Nguyen, AGACNP
• Tamanh Nguyen

• Marriage & Family Therapist in Hawthorne, CA
• Providers in Hawthorne, 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 Jan 13, 2023; 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.