Individual provider Active NPI

Javier Andres Donahoe

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1437326428
Registry record updated Sep 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
95074 Issued in CA
Practice address
5849 Crocker St
Los Angeles, CA 90003-1311
Phone
(323) 234-4445
Fax
(323) 234-4477
NPI assigned
May 9, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2016

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 95074 CA Primary

Addresses

Primary practice location

5849 Crocker St
Los Angeles, CA 90003-1311

Mailing address

5849 Crocker St
Los Angeles, CA 90003-1311
Phone (323) 234-4445

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
I20260414001218 CA Practitioner - Marriage and Family Therapist 0446726830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

818 N Mountain Ave
Suite 219
Upland, CA 91786-4165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95074CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cleansing Conversations Marriage & Family Therapist CurrentSince Aug 23, 2020 Accepting new patients
Cleansing Conversations Inc. Current Accepting new patients
Special Service for Groups, Inc. Past Accepting new patients

Locations

10630 Town Center Dr
Ste 119
Rch Cucamonga, CA 91730
Phone (951) 536-2564

3393 14th St
Ste A
Riverside, CA 92501
Phone (951) 534-0044

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": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1437326428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5849 CROCKER ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900031311",
            "telephone_number": "323-234-4445",
            "fax_number": "323-234-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5849 CROCKER ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900031311",
            "telephone_number": "323-234-4445",
            "fax_number": "323-234-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONAHOE",
        "first_name": "JAVIER",
        "middle_name": "ANDRES",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-09",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "95074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.