Individual provider Active NPI

Andre Sy, AMFT

  • Marriage & Family Therapist
  • Pomona, CA
National Provider Identifier
1285106740
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
110053 Issued in CA
Practice address
30 Country Wood Dr
Pomona, CA 91766-4818
Phone
(909) 623-3400
Fax
(909) 599-8223
NPI assigned
Dec 21, 2018
Last updated
Feb 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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 110053 CA Primary

Addresses

Primary practice location

30 Country Wood Dr
Pomona, CA 91766-4818

Mailing address

701 W Imperial Hwy Apt 512
La Habra, CA 90631-7055
Phone (714) 928-9101

Other practice location 1

1923 E Eckerman Ave
West Covina, CA 91791-1113
Phone (626) 332-4600

Other practice location 2

670 W Baseline Rd
San Dimas, CA 91773-1492
Phone (909) 741-7124

Other practice location 3

1940 Baseline Rd
LA Verne, CA 91750-2148
Phone (909) 392-1344

Other practice location 4

3340 E Whitebirch Dr
West Covina, CA 91791-3039
Phone (626) 430-6864

Other practice location 5

16226 Benwick St
LA Puente, CA 91744-1301
Phone (626) 917-0857

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

LicenseStateTypeSpecialty
110053CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Group Homes, Inc. PastSince Feb 24, 2022 Accepting new patients
Heritage Group Homes Inc. PastSince Jun 15, 2021 Accepting new patients
Heritage Group Homes, Inc. Past Accepting new patients
Heritage Group Homes, Inc. Past Accepting new patients
Heritage Group Homes, Inc. PastSince Oct 31, 2021 Accepting new patients
Heritage Group Homes, Inc. PastSince Aug 6, 2019 Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1545350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1285106740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W IMPERIAL HWY APT 512",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906317055",
            "telephone_number": "714-928-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 COUNTRY WOOD DR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917664818",
            "telephone_number": "909-623-3400",
            "fax_number": "909-599-8223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1923 E Eckerman Ave",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917911113",
            "country_code": "US",
            "telephone_number": "626-332-4600",
            "fax_number": "909-599-8223",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "670 W Baseline Rd",
            "address_purpose": "LOCATION",
            "city": "San Dimas",
            "state": "CA",
            "postal_code": "917731492",
            "country_code": "US",
            "telephone_number": "909-741-7124",
            "fax_number": "909-599-8223",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1940 Baseline Rd",
            "address_purpose": "LOCATION",
            "city": "LA Verne",
            "state": "CA",
            "postal_code": "917502148",
            "country_code": "US",
            "telephone_number": "909-392-1344",
            "fax_number": "909-599-8223",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3340 E Whitebirch Dr",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917913039",
            "country_code": "US",
            "telephone_number": "626-430-6864",
            "fax_number": "909-599-8223",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16226 Benwick St",
            "address_purpose": "LOCATION",
            "city": "LA Puente",
            "state": "CA",
            "postal_code": "917441301",
            "country_code": "US",
            "telephone_number": "626-917-0857",
            "fax_number": "909-599-8223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SY",
        "first_name": "ANDRE",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-21",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "110053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.