Individual provider Active NPI

Andrea Elizabeth Canseco-de Leon, LMFT

  • Mental Health Counselor
  • Huntington Park, CA
National Provider Identifier
1467913541
Registry record updated Mar 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LMFT85855 Issued in CA
Practice address
2677 Zoe Ave Ste 120
Huntington Park, CA 90255-6995
Phone
(323) 589-1902
Fax
(323) 589-1805
NPI assigned
Mar 29, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X LMFT85855 CA Primary

Addresses

Primary practice location

2677 Zoe Ave Ste 120
Huntington Park, CA 90255-6995

Mailing address

2677 Zoe Ave Ste 120
Huntington Park, CA 90255-6995
Phone (323) 589-1902

Other names 1

  • Andrea Elizabeth Canseco Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address andrea@cdf-centro.com Direct

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

LicenseStateTypeSpecialty
LMFT85855CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553817600000",
    "number": "1467913541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2677 ZOE AVE STE 120",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902556995",
            "telephone_number": "323-589-1902",
            "fax_number": "323-589-1805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2677 ZOE AVE STE 120",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902556995",
            "telephone_number": "323-589-1902",
            "fax_number": "323-589-1805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANSECO-DE LEON",
        "first_name": "ANDREA",
        "middle_name": "ELIZABETH",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2019-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LMFT85855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "andrea@cdf-centro.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2677 Zoe Ave Ste 120",
            "city": "Huntington Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902556995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "CANSECO",
            "middle_name": "ELIZABETH",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Huntington Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.

Verify at the official NPI Registry.