Active NPI
Wylma Joyce Gibbs, MFT
- Marriage & Family Therapist
- Pasadena, CA
National Provider Identifier
1295867901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC 49020
- Practice address
- 1789 Walworth Ave
Pasadena, CA 91104-1238 - Phone
- (626) 827-0418
- NPI assigned
- Mar 9, 2007
- Last updated
- Mar 17, 2014
- Sex
- Female
- Sole proprietor
- No
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 | MFC 49020 | CA | Primary |
Addresses
Primary practice location
1789 Walworth Ave
Pasadena, CA 91104-1238
Mailing address
1891 Effie St
Los Angeles, CA 90026-1711
Phone (323) 644-2000
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 |
|---|---|---|---|
| MFC 49020 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ellen Mental Health Inc | Marriage & Family Therapist | Current | Accepting new patients |
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, 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": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395014400000",
"number": "1295867901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1891 EFFIE ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900261711",
"telephone_number": "323-644-2000",
"fax_number": "323-644-2793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1789 WALWORTH AVE",
"city": "PASADENA",
"state": "CA",
"postal_code": "911041238",
"telephone_number": "626-827-0418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBS",
"first_name": "WYLMA",
"middle_name": "JOYCE",
"credential": "MFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-09",
"last_updated": "2014-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC 49020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.