Talia Bombola, LMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

122456 Issued in CA

Practice address

5020 Campus Drive
#27
Newport Beach, CA 92660-2120

Phone

(949) 478-1798

NPI assigned

Oct 15, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Marriage and Family Therapist

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shanti Orange CountyGroup PAC ID 9537475736, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Shanti Orange County

  • Adult Mental Health Clinic/Center
  • Laguna Hills, CA
  • NPI 1447656418
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1235737875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5020 CAMPUS DR # 27",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602120",
            "telephone_number": "949-478-1798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5020 CAMPUS DRIVE",
            "address_2": "#27",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602120",
            "telephone_number": "949-478-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMBOLA",
        "first_name": "TALIA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "122456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose Bolanos
• Michael Scott Bold, OD
• Elizabeth Bolduc, RD
• Susan A Bollinger, DDS
• Cindy Bollman, PH.D.
• Monica Bonakdar, MD
• David Kyle Bond, PHD
• Jeffrey Kitts Bone, PSY.D.
• Sara Maribel Bonilla-Lopez
• Emily Elizabeth Bonilla

• Mental Health Counselor in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.