Antoinette de Leon Licensed Marriage and Family Therapist Inc

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

ANTOINETTE DE LEON LICENSED MARRIAGE AND FAMILY THERAPIST INC

Practice address

16060 Ventura Blvd
Unit 110 PMB 1012
Encino, CA 91436-4916

Phone

(818) 421-7020

NPI assigned

Mar 28, 2022

Organization subpart

No

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

Authorized official

Name

Antoinette De Leon, LMFTNPI 1417584475

Title

Ceo

Phone

(818) 421-7020

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Antoinette De Leon

  • Marriage & Family Therapist
  • Encino, CA
  • NPI 1417584475
  NPD Authorized official

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654387200000",
    "number": "1306596507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 BALBOA BLVD #261054",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914267052",
            "telephone_number": "818-421-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16060 VENTURA BLVD",
            "address_2": "UNIT 110 PMB 1012",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364916",
            "telephone_number": "818-421-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTOINETTE DE LEON LICENSED MARRIAGE AND FAMILY THERAPIST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-28",
        "last_updated": "2022-06-05",
        "certification_date": "2022-06-05",
        "status": "A",
        "authorized_official_last_name": "DE LEON",
        "authorized_official_first_name": "ANTOINETTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-421-7020",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Encino, CA
• Providers in Encino, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.