Individual provider Active NPI

Socorro Buenaventura, LMFT

  • Marriage & Family Therapist
  • Pomona, CA
National Provider Identifier
1336270339
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT39133 Issued in CA
Practice address
790 E Bonita Ave
Pomona, CA 91767
Phone
(909) 625-7207
NPI assigned
Mar 8, 2007
Last updated
Jan 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 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 LMFT39133 CA Primary

Addresses

Primary practice location

790 E Bonita Ave
Pomona, CA 91767

Mailing address

790 E Bonita Ave
Pomona, CA 91767-1906
Phone (909) 625-7207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240229002745 CA Practitioner - Marriage and Family Therapist 6002251014 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT39133CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Clinics CurrentSince Aug 20, 2025 Accepting new patients
Pacific Clinics Current Accepting new patients

Locations

251 Llewellyn Ave
Campbell, CA 95008
Phone (408) 364-4083

1020 S Arroyo Pkwy
Pasadena, CA 91105
Phone (626) 403-2794

790 E Bonita Ave
Pomona, CA 91767
Phone (909) 625-7207

Organizations & group practices 2

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1336270339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 E BONITA AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671906",
            "telephone_number": "909-625-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 E BONITA AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "91767",
            "telephone_number": "909-625-7207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUENAVENTURA",
        "first_name": "SOCORRO",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT39133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.