Individual provider Active NPI

Charles Timothy Eby-McKenzie, LMFT

  • Marriage & Family Therapist
  • Pasadena, CA
National Provider Identifier
1346578366
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC33594 Issued in CA
Practice address
595 E Colorado Blvd Ste 331
Pasadena, CA 91101-5225
Phone
(818) 281-6109
NPI assigned
Dec 2, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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 MFC33594 CA Primary

Addresses

Primary practice location

595 E Colorado Blvd Ste 331
Pasadena, CA 91101-5225

Mailing address

595 E Colorado Blvd Ste 331
Pasadena, CA 91101-5225
Phone (818) 281-6109

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

LicenseStateTypeSpecialty
MFC33594CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1259712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1346578366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 E COLORADO BLVD STE 331",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911015225",
            "telephone_number": "818-281-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 E COLORADO BLVD STE 331",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911015225",
            "telephone_number": "818-281-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBY-MCKENZIE",
        "first_name": "CHARLES",
        "middle_name": "TIMOTHY",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-02",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC33594",
            "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 Feb 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.