Individual provider Active NPI

Deborah Hideko Antonio, B.A., R.N.

  • Mental Health Counselor
  • Pasadena, CA
National Provider Identifier
1396997839
Registry record updated Oct 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2555 E Colorado Blvd
Suite 100
Pasadena, CA 91107-6622
Phone
(626) 577-2261
Fax
(626) 577-2543
NPI assigned
Oct 15, 2008
Last updated
Oct 15, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2555 E Colorado Blvd
Suite 100
Pasadena, CA 91107-6622

Mailing address

433 S Griffith Park Dr
Burbank, CA 91506-2716
Phone (818) 845-9099

Other identifiers 1

IdentifierTypeStateIssuer
ICAN837OtherCALA COUNTY DMH

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, Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224028800000",
    "number": "1396997839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 S GRIFFITH PARK DR",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915062716",
            "telephone_number": "818-845-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 E COLORADO BLVD",
            "address_2": "SUITE 100",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911076622",
            "telephone_number": "626-577-2261",
            "fax_number": "626-577-2543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONIO",
        "first_name": "DEBORAH",
        "middle_name": "HIDEKO",
        "name_prefix": "Ms.",
        "credential": "B.A., R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-15",
        "last_updated": "2008-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA COUNTY DMH",
            "identifier": "ICAN837",
            "state": "CA"
        }
    ],
    "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 Oct 15, 2008; 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.