Individual provider Active NPI

Daniella Cherise Pavone, MA, LMFT

  • Marriage & Family Therapist
  • Redding, CA
National Provider Identifier
1417627290
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
143032 Issued in CA
Practice address
2135 Pine St
Redding, CA 96001-2690
Phone
(530) 276-0624
NPI assigned
Sep 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 143032 CA Primary

Addresses

Primary practice location

2135 Pine St
Redding, CA 96001-2690

Mailing address

PO Box 491750
Redding, CA 96049-1750
Phone (530) 722-9957

Other practice location 1

1170 Industrial St
Redding, CA 96002-0734
Phone (530) 722-9957

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
I20240103004782 CA Practitioner - Marriage and Family Therapist 5294186227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Creekside Counseling Center IncGroup PAC ID 1557683315, 16 clinicians

Practice addresses (Care Compare)

1170 Industrial St
Redding, CA 96002-0734
Phone (530) 722-9957

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Pavone Family Therapy, Inc Marriage & Family Therapist Current Accepting new patients
Creekside Counseling Center Inc Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients
Medical Social Services Consultation, Inc PastSince Sep 23, 2021 Accepting new patients

Locations

2135 Pine St
Redding, CA 96001
Phone (530) 276-0624

1170 Industrial St
Redding, CA 96002
Phone (530) 722-9957

Organizations & group practices 3

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": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1417627290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 491750",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960491750",
            "telephone_number": "530-722-9957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2135 PINE ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012690",
            "telephone_number": "530-276-0624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1170 Industrial St",
            "address_purpose": "LOCATION",
            "city": "Redding",
            "state": "CA",
            "postal_code": "960020734",
            "country_code": "US",
            "telephone_number": "530-722-9957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAVONE",
        "first_name": "DANIELLA",
        "middle_name": "CHERISE",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "143032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.