Active NPI
Andrew Alberto Pantoja, BA
- Marriage & Family Therapist
- View Park, CA
National Provider Identifier
1366904500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 147557
- Practice address
- 5300 Angeles Vista Blvd
View Park, CA 90043-1648 - Phone
- (323) 295-4555
- NPI assigned
- Apr 5, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | CA | ||
| Marriage & Family Therapist | 106H00000X | 147557 | CA | Primary |
Addresses
Primary practice location
5300 Angeles Vista Blvd
View Park, CA 90043-1648
Mailing address
1045 Bonita Ave
La Verne, CA 91750-5109
Phone (310) 912-2021
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
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 147557 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wayfinder Family Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- San Dimas, CA
- NPI 1427519784
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722384000000",
"number": "1366904500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1045 BONITA AVE",
"city": "LA VERNE",
"state": "CA",
"postal_code": "917505109",
"telephone_number": "310-912-2021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5300 ANGELES VISTA BLVD",
"city": "VIEW PARK",
"state": "CA",
"postal_code": "900431648",
"telephone_number": "323-295-4555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANTOJA",
"first_name": "ANDREW",
"middle_name": "ALBERTO",
"credential": "BA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-05",
"last_updated": "2024-07-31",
"certification_date": "2024-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "147557",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in View Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.