Individual provider Active NPI

Octavia Macklin, LMFT

  • Marriage & Family Therapist
  • Cerritos, CA
National Provider Identifier
1356845150
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
155858 Issued in CA
Practice address
11331 183Rd St # 1140
Cerritos, CA 90703-5434
Phone
(562) 221-2113
NPI assigned
Mar 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 155858 CA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X R1315860718 CA

Addresses

Primary practice location

11331 183Rd St # 1140
Cerritos, CA 90703-5434

Mailing address

11331 183Rd St # 1140
Cerritos, CA 90703-5434
Phone (562) 221-2113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • 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
I20250814004235 CA Practitioner - Marriage and Family Therapist 3173022415 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Blue Psychological ServicesGroup PAC ID 3678908357, 23 clinicians
Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Practice addresses (Care Compare)

15235 Burbank Blvd
Suite A2
Sherman Oaks, CA 91411-3555
Phone (310) 306-0335

4633 Old Ironsides Dr
Suite 304
Santa Clara, CA 95054-1846
Phone (866) 280-0260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R1315860718CAMDAddiction (Substance Use Disorder) Counselor
155858CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sud Specialty Group - Ca Addiction (Substance Use Disorder) CurrentSince Sep 1, 2025 Accepting new patients
Pacific Blue Psychological Services CurrentSince Jul 21, 2025 Accepting new patients

Locations

3570 E Imperial Hwy
Lynwood, CA 90262
Phone (858) 883-3277

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

15235 Burbank Blvd
Ste A2
Van Nuys, CA 91411
Phone (949) 504-1963

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1356845150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11331 183RD ST # 1140",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907035434",
            "telephone_number": "562-221-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11331 183RD ST # 1140",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907035434",
            "telephone_number": "562-221-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKLIN",
        "first_name": "OCTAVIA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-19",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "155858",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1315860718",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

Verify at the official NPI Registry.