Mireya Badillo-Vasquez, LMFT #128617

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT128617 Issued in CA

Practice address

5628 E Slauson Ave
Commerce, CA 90040-2922

Phone

(323) 318-9960

NPI assigned

Nov 25, 2015

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1448409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1174997381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5628 E SLAUSON AVE",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900402922",
            "telephone_number": "323-318-9960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5628 E SLAUSON AVE",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900402922",
            "telephone_number": "323-318-9960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADILLO-VASQUEZ",
        "first_name": "MIREYA",
        "credential": "LMFT #128617",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF90240",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT128617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "95-2633765",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sreedevi Jadcherla Ayyala, MD
• Hirsa Azizi, DC
• B&R Wound Care
• Heliodoro Baca
• Back to Work Orthopedic Medical Group
• Yaghoub Badymoghaddam, M.D.
• Biridiana Baez
• Reina Angelica Baez, M.A.
• Ursula Maria Baffigo, M.D.
• Patricia D Baker-Soto

• Marriage & Family Therapist in Commerce, CA
• Providers in Commerce, 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 25, 2021; 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.