Active NPI
Guillermo Pina, AMFT140631
- Marriage & Family Therapist
- Perris, CA
National Provider Identifier
1184196321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- AMFT140631
- Practice address
- 450 E San Jacinto Ave
Perris, CA 92571-2833 - Phone
- (951) 236-5193
- Fax
- (951) 784-4976
- NPI assigned
- Dec 28, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4120 | CA | |
| Case Manager/Care Coordinator | 171M00000X | |||
| Marriage & Family Therapist | 106H00000X | AMFT140631 | CA | Primary |
Addresses
Primary practice location
450 E San Jacinto Ave
Perris, CA 92571-2833
Mailing address
450 E San Jacinto Ave
Perris, CA 92571-2833
Phone (951) 236-5193
Other practice location 1
1140 W 9th St Apt 18
San Bernardino, CA 92411
Phone (760) 580-1666
Other practice location 2
516 Bradford Dr
Slidell, LA 70461-4910
Phone (760) 580-1666
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AMFT140631 | CA | MD | Marriage & Family Therapist |
| 4120 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694131200000",
"number": "1184196321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 E SAN JACINTO AVE",
"city": "PERRIS",
"state": "CA",
"postal_code": "925712833",
"telephone_number": "951-236-5193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 E SAN JACINTO AVE",
"city": "PERRIS",
"state": "CA",
"postal_code": "925712833",
"telephone_number": "951-236-5193",
"fax_number": "951-784-4976"
}
],
"practiceLocations": [
{
"address_1": "1140 W 9th St Apt 18",
"address_purpose": "LOCATION",
"city": "San Bernardino",
"state": "CA",
"postal_code": "92411",
"country_code": "US",
"telephone_number": "760-580-1666",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "516 Bradford Dr",
"address_purpose": "LOCATION",
"city": "Slidell",
"state": "LA",
"postal_code": "704614910",
"country_code": "US",
"telephone_number": "760-580-1666",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PINA",
"first_name": "GUILLERMO",
"credential": "AMFT140631",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-28",
"last_updated": "2023-09-08",
"certification_date": "2023-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "4120",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "AMFT140631",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Perris, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.