Individual provider Active NPI

Mateo Leonardo, AMFT

  • Marriage & Family Therapist
  • Long Beach, CA
National Provider Identifier
1194478826
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
130167 Issued in CA
Practice address
329 1/2 Gladys Ave
Long Beach, CA 90814-2424
Phone
(310) 363-5154
NPI assigned
Feb 2, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 130167 CA Primary

Addresses

Primary practice location

329 1/2 Gladys Ave
Long Beach, CA 90814-2424

Mailing address

329 1/2 Gladys Ave
Long Beach, CA 90814-2424
Phone (310) 363-5154

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 10, 2025 through Apr 10, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
130167CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1194478826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 1/2 GLADYS AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908142424",
            "telephone_number": "310-363-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 1/2 GLADYS AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908142424",
            "telephone_number": "310-363-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARDO",
        "first_name": "MATEO",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-02",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "130167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.