Active NPI
Theresa Marie Collins, LMFT
- Marriage & Family Therapist
- La Canada, CA
National Provider Identifier
1396980207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT 52283
- Practice address
- 1313 Foothill Blvd Ste 9
La Canada, CA 91011-2163 - Phone
- (626) 622-2449
- Fax
- (818) 957-7772
- NPI assigned
- Dec 5, 2008
- Last updated
- Mar 29, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 52283 | CA | |
| Marriage & Family Therapist | 106H00000X | MFT 52283 | CA | Primary |
Addresses
Primary practice location
1313 Foothill Blvd Ste 9
La Canada, CA 91011-2163
Mailing address
3428 Community Ave
La Crescenta, CA 91214-2520
Phone (626) 622-2449
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7708 | Other | CA | MEDICAL |
| 7368 | Other | CA | MEDICAL |
| 7667 | Other | CA | MEDICAL |
| 7184 | Other | CA | MEDICAL |
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 |
|---|---|---|---|
| MFT 52283 | CA | MD | Marriage & Family Therapist |
| 52283 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522281600000",
"number": "1396980207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3428 COMMUNITY AVE",
"city": "LA CRESCENTA",
"state": "CA",
"postal_code": "912142520",
"telephone_number": "626-622-2449",
"fax_number": "818-957-7772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1313 FOOTHILL BLVD STE 9",
"city": "LA CANADA",
"state": "CA",
"postal_code": "910112163",
"telephone_number": "626-622-2449",
"fax_number": "818-957-7772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "THERESA",
"middle_name": "MARIE",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-05",
"last_updated": "2018-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "52283",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFT 52283",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "7708",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "7368",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "7667",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "7184",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in La Canada, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.