Active NPI
Shellie Suzanne Tapia, LMFT, RBT
- Marriage & Family Therapist
- Rancho Cucamonga, CA
National Provider Identifier
1407253495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 83377
- Practice address
- 10777 Civic Center Dr
Rancho Cucamonga, CA 91730-3806 - Phone
- (909) 948-3536
- NPI assigned
- Nov 19, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-16-18596 | ||
| Marriage & Family Therapist | 106H00000X | 83377 | CA | Primary |
Addresses
Primary practice location
10777 Civic Center Dr
Rancho Cucamonga, CA 91730-3806
Mailing address
10777 Civic Center Dr
Rancho Cucamonga, CA 91730-3806
Phone (909) 948-3536
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 |
|---|---|---|---|
| 83377 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Oak Counseling Services, Inc. | Marriage & Family Therapist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Marriage & Family Therapist
- Ontario, CA
- NPI 1073124285
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565913600000",
"number": "1407253495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10777 CIVIC CENTER DR",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917303806",
"telephone_number": "909-948-3536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10777 CIVIC CENTER DR",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917303806",
"telephone_number": "909-948-3536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAPIA",
"first_name": "SHELLIE",
"middle_name": "SUZANNE",
"name_prefix": "Mrs.",
"credential": "LMFT, RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-19",
"last_updated": "2019-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": "RBT-16-18596",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "83377",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Cucamonga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.