Active NPI
Andre Estephan
- Marriage & Family Therapist
- Pasadena, CA
National Provider Identifier
1336527563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 85912
- Practice address
- 3827 E Colorado Blvd
Pasadena, CA 91107-3935 - Phone
- (626) 327-5711
- NPI assigned
- May 7, 2015
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 85912 | CA | Primary |
Addresses
Primary practice location
3827 E Colorado Blvd
Pasadena, CA 91107-3935
Mailing address
950 W Sierra Madre Ave
Apt 614
Azusa, CA 91702-1800
Phone (626) 327-5711
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 |
|---|---|---|---|
| 85912 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430956800000",
"number": "1336527563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 W SIERRA MADRE AVE",
"address_2": "APT 614",
"city": "AZUSA",
"state": "CA",
"postal_code": "917021800",
"telephone_number": "626-327-5711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3827 E COLORADO BLVD",
"city": "PASADENA",
"state": "CA",
"postal_code": "911073935",
"telephone_number": "626-327-5711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTEPHAN",
"first_name": "ANDRE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-05-07",
"last_updated": "2015-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "85912",
"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 May 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.