Active NPI
Avana Pace
- Marriage & Family Therapist
- North Hollywood, CA
National Provider Identifier
1336842012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 137196
- Practice address
- 5536 Fulcher Ave Apt 506
North Hollywood, CA 91601-2591 - Phone
- (805) 558-4129
- NPI assigned
- Mar 23, 2023
- Sex
- Female
- 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 | 137196 | CA | Primary |
Addresses
Primary practice location
5536 Fulcher Ave Apt 506
North Hollywood, CA 91601-2591
Mailing address
4548 Vista del Valle Dr
Moorpark, CA 93021-2214
Phone (805) 558-4129
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 |
|---|---|---|---|
| 137196 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679529600000",
"number": "1336842012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4548 VISTA DEL VALLE DR",
"city": "MOORPARK",
"state": "CA",
"postal_code": "930212214",
"telephone_number": "805-558-4129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5536 FULCHER AVE APT 506",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "916012591",
"telephone_number": "805-558-4129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACE",
"first_name": "AVANA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-23",
"last_updated": "2023-03-23",
"certification_date": "2023-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "137196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Hollywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.