Active NPI
Penny Elizabeth King-Licano, LMFT
- Marriage & Family Therapist
- Long Beach, CA
National Provider Identifier
1437284577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT114472
- Practice address
- 100 E Wardlow Rd
Long Beach, CA 90807-4417 - Phone
- (562) 427-6818
- NPI assigned
- Feb 22, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LMFT114472 | CA | Primary |
Addresses
Primary practice location
100 E Wardlow Rd
Long Beach, CA 90807-4417
Mailing address
1501 Hughes Way Ste 150
Long Beach, CA 90810-1878
Phone (562) 293-5890
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 |
|---|---|---|---|
| LMFT114472 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572480000000",
"number": "1437284577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 HUGHES WAY STE 150",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908101878",
"telephone_number": "562-293-5890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E WARDLOW RD",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908074417",
"telephone_number": "562-427-6818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING-LICANO",
"first_name": "PENNY",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-22",
"last_updated": "2019-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "LMFT114472",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.