Active NPI
Tillie Renee Reitsma, LMFT
- Marriage & Family Therapist
- Upland, CA
National Provider Identifier
1255790671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT90683
- Practice address
- 123 E 9TH St
Ste. 100C
Upland, CA 91786-6023 - Phone
- (951) 532-8333
- NPI assigned
- Feb 12, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LMFT90683 | CA | Primary |
Addresses
Primary practice location
123 E 9TH St
Ste. 100C
Upland, CA 91786-6023
Mailing address
1604 N Palm Ave
Upland, CA 91784-1922
Phone (951) 532-8333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMFT90683 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482451200000",
"number": "1255790671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1604 N PALM AVE",
"city": "UPLAND",
"state": "CA",
"postal_code": "917841922",
"telephone_number": "951-532-8333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 E 9TH ST",
"address_2": "STE. 100C",
"city": "UPLAND",
"state": "CA",
"postal_code": "917866023",
"telephone_number": "951-532-8333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REITSMA",
"first_name": "TILLIE",
"middle_name": "RENEE",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-12",
"last_updated": "2016-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "LMFT90683",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Upland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.