Individual provider Active NPI

Reginald Eric Bland Jr.

  • Marriage & Family Therapist
  • Pasadena, CA
National Provider Identifier
1184967101
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT123696 Issued in CA
Practice address
100 W Walnut St Ste 375
Pasadena, CA 91124-2074
Phone
(626) 395-7100
NPI assigned
Mar 27, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 123696 CA
Rehabilitation Practitioner 225400000X
Marriage & Family Therapist 106H00000X AMFT123696 CA Primary

Addresses

Primary practice location

100 W Walnut St Ste 375
Pasadena, CA 91124-2074

Mailing address

100 W Walnut St Ste 375
Pasadena, CA 91124-0001
Phone (626) 395-7100

Other identifiers 1

IdentifierTypeStateIssuer
123696OtherCACALIFORNIA BOARD OF BEHAVIORAL SCIENCES

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

LicenseStateTypeSpecialty
123696CAMDMarriage & Family Therapist
AMFT123696CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1184967101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W WALNUT ST STE 375",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911240001",
            "telephone_number": "626-395-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W WALNUT ST STE 375",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911242074",
            "telephone_number": "626-395-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAND",
        "first_name": "REGINALD",
        "middle_name": "ERIC",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-27",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "123696",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT123696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "123696",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.