Abigail Avalos
Individual provider Active NPI Marriage & Family Therapist · South Pasadena, CA
NPI 1235730342 · NPPES record last updated Jun 30, 2023
Key facts
- NPI
- 1235730342
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 121468 (CA)
- Practice address
- 205 Pasadena Ave
South Pasadena, CA 91030-2919 - Phone
- (323) 344-5536
- Fax
- (323) 344-5550
- NPI assigned
- Nov 4, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AMFT121468 | CA | MD | Mental Health Counselor |
| 121468 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Institute for the Redesign of Learning | Mental Health | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | AMFT121468 | CA | |
| Marriage & Family Therapist | 106H00000X | 121468 | CA | Yes |
Addresses
Primary practice location
205 Pasadena Ave
South Pasadena, CA 91030-2919
Mailing address
205 Pasadena Ave
South Pasadena, CA 91030-2919
Phone (323) 344-5536
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7184 | Other | CA | MEDI-CAL |
| 7667 | Other | CA | MEDI-CAL |
| 7708 | Other | CA | MEDI-CAL |
| 7368 | Other | CA | MEDI-CAL |
Other providers in South Pasadena, CA
- Arroyo Seco Family Therapy Inc.
- Beatriz Jacobo Arteaga
- At Your Pace Family Therapy, Inc
- Atp Physical Therapy PC
- Maria Dawn Austin
- Alice Avedikian
- Vanessa Annettie Franklin Axelrod
- Luz Ayon
- Monica Babaian
- Bachour-Lu Dental Corporation
All providers in South Pasadena, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.