Individual provider Active NPI

Laura Cisneros, LMFT

  • Marriage & Family Therapist
  • Brea, CA
National Provider Identifier
1255606646
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
117159 Issued in CA
Practice address
3350 E Birch St Ste 206
Brea, CA 92821-6267
Phone
(562) 431-8822
NPI assigned
Mar 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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 117159 CA Primary

Addresses

Primary practice location

3350 E Birch St Ste 206
Brea, CA 92821-6267

Mailing address

3350 E Birch St Ste 206
Brea, CA 92821-6267

Other practice location 1

3031 S Vermont Ave
Los Angeles, CA 90007
Phone (323) 373-2400

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240809000773 CA Practitioner - Marriage and Family Therapist 1254878135 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc CurrentSince Jun 26, 2024 Accepting new patients

Locations

3350 E Birch St
Ste 206
Brea, CA 92821
Phone (562) 725-4966

4040 Barranca Pkwy
Ste 260
Irvine, CA 92604

6200 Wilshire Blvd
Ste 1410
Los Angeles, CA 90048
Phone (323) 403-0474

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

12215 Telegraph Rd
Ste 107
Santa Fe Springs, CA 90670

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.lauracisneros@148377.advancedmd-direct.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1255606646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 E BIRCH ST STE 206",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928216267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 E BIRCH ST STE 206",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928216267",
            "telephone_number": "562-431-8822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3031 S Vermont Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90007",
            "country_code": "US",
            "telephone_number": "323-373-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CISNEROS",
        "first_name": "LAURA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-19",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "117159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

Verify at the official NPI Registry.