Active NPI
Eugenio Venegas, MFT INTERN
- Specialist
- Highland Park, CA
National Provider Identifier
1316063522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 52600
- Practice address
- 5420 N Figueroa St
Highland Park, CA 90042-4118 - Phone
- (323) 999-2404
- NPI assigned
- Mar 21, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 52600 | CA | Primary |
Addresses
Primary practice location
5420 N Figueroa St
Highland Park, CA 90042-4118
Mailing address
5420 N Figueroa St
Highland Park, CA 90042-4118
Phone (323) 999-2402
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 |
|---|---|---|---|
| 52600 | CA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316063522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5420 N FIGUEROA ST",
"city": "HIGHLAND PARK",
"state": "CA",
"postal_code": "900424118",
"telephone_number": "323-999-2402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5420 N FIGUEROA ST",
"city": "HIGHLAND PARK",
"state": "CA",
"postal_code": "900424118",
"telephone_number": "323-999-2404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENEGAS",
"first_name": "EUGENIO",
"name_prefix": "Mr.",
"credential": "MFT INTERN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "52600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Highland Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.