Individual provider Active NPI

Juan Carlos Calderon

  • Marriage & Family Therapist
  • Long Beach, CA
National Provider Identifier
1467226480
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
159465 Issued in CA
Practice address
1301 Pine Ave
Long Beach, CA 90813-3124
Phone
(562) 595-1159
NPI assigned
Nov 9, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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 159465 CA Primary

Addresses

Primary practice location

1301 Pine Ave
Long Beach, CA 90813-3124

Mailing address

1301 Pine Ave
Long Beach, CA 90813-3124
Phone (562) 595-1159

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
I20260205001463 CA Practitioner - Marriage and Family Therapist 0042799579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

854 W Wilson St
Costa Mesa, CA 92627-3334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
159465CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sud Specialty Group - Ca Marriage & Family Therapist CurrentSince Jan 22, 2026 Accepting new patients

Locations

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1699488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1467226480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PINE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133124",
            "telephone_number": "562-595-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PINE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133124",
            "telephone_number": "562-595-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERON",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-09",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "159465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.