Elizabeth Iaquinto, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT149510 Issued in CA

Practice address

420 Bullard Ave Ste E
Clovis, CA 93612-1054

Phone

(559) 679-9220

NPI assigned

Aug 28, 2019

Last updated

Dec 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846
  Medicare reassignment NPD
• Sud Specialty Group - Ca

  dba Rula Health

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Marriage & Family Therapist

  Medicare reassignment NPD
• Elizabeth Iaquinto Licensed Marriage and Family Therapist Inc

  dba Poppy Ridge Wellness and Therapy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clovis, CA
  • NPI 1174336135
  NPD Authorized official
• Tulare County Office of Education

  • Local Education Agency (LEA)
  • Visalia, CA
  • NPI 1457612004
  NPD (past)

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1225686769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5333 N SANTA FE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937112639",
            "telephone_number": "559-679-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 BULLARD AVE STE E",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936121054",
            "telephone_number": "559-679-9220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6276 N 1st St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937105400",
            "country_code": "US",
            "telephone_number": "559-712-4300",
            "fax_number": "559-412-7564",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1040 E Herndon Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937203158",
            "country_code": "US",
            "telephone_number": "559-712-4300",
            "fax_number": "559-412-7564",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4041 N Fresno St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937264038",
            "country_code": "US",
            "telephone_number": "559-712-4300",
            "fax_number": "559-412-7564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IAQUINTO",
        "first_name": "ELIZABETH",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT149510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BBS",
            "identifier": "AMF122867",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Alexandra Nicole Iared, D.C.
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• Arsany Ibrahim, PHARM.D.
• Innocent Idusuyi
• Omer Ilyas, M.D.

• Marriage & Family Therapist in Clovis, CA
• Providers in Clovis, 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 Dec 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.