Individual provider Active NPI

Nikita Ravindra Bangera

  • Marriage & Family Therapist
  • Roseville, CA
National Provider Identifier
1184440414
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
141439 Issued in CA
Practice address
1382 Blue Oaks Blvd Ste 213
Roseville, CA 95678-7052
Phone
(877) 412-8031
NPI assigned
Dec 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 141439 CA Primary
Mental Health Counselor 101YM0800X 15390 CA

Addresses

Primary practice location

1382 Blue Oaks Blvd Ste 213
Roseville, CA 95678-7052

Mailing address

3656 Castle Reagh PL
Riverside, CA 92506-1219
Phone (510) 634-5938

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Together Mental Health CurrentSince Dec 8, 2024 Accepting new patients

Locations

1382 Blue Oaks Blvd
Ste 213
Roseville, CA 95678
Phone (877) 412-8031

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": "1733097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1184440414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3656 CASTLE REAGH PL",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925061219",
            "telephone_number": "510-634-5938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1382 BLUE OAKS BLVD STE 213",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956787052",
            "telephone_number": "877-412-8031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANGERA",
        "first_name": "NIKITA RAVINDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-02",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "141439",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "15390",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.