Individual provider Active NPI

Berenise Noblecilla Whiteleather

  • Marriage & Family Therapist
  • Cerritos, CA
National Provider Identifier
1356700587
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT102309 Issued in CA
Practice address
17707 Studebaker Rd
Cerritos, CA 90703-2640
Phone
(562) 402-0688
NPI assigned
Feb 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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 LMFT102309 CA Primary

Addresses

Primary practice location

17707 Studebaker Rd
Cerritos, CA 90703-2640

Mailing address

17707 Studebaker Rd
Cerritos, CA 90703-2640
Phone (562) 402-0688

Other names 1

  • Berenise Noblecila Former name

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
I20240109003723 CA Practitioner - Marriage and Family Therapist 8325499825 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT102309CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Amanecer Community Counseling Service, a Non-Profit Corporation PastSince Sep 1, 2022 Accepting new patients
Union Ave Elementary School Past Accepting new patients

Locations

17707 Studebaker Rd
Cerritos, CA 90703
Phone (562) 402-0688

17707 Studebaker Rd
#150
Cerritos, CA 90703
Phone (310) 402-0688

10515 Balboa Blvd
Granada Hills, CA 91344
Phone (818) 486-3837

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1356700587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17707 STUDEBAKER RD",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032640",
            "telephone_number": "562-402-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17707 STUDEBAKER RD",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032640",
            "telephone_number": "562-402-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITELEATHER",
        "first_name": "BERENISE",
        "middle_name": "NOBLECILLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-16",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT102309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BERENISE",
            "last_name": "NOBLECILA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cerritos, CA

Sources for this page

Verify at the official NPI Registry.