Individual provider Active NPI

Alicia Taverner, LMFT

  • Marriage & Family Therapist
  • Rancho Cucamonga, CA
National Provider Identifier
1497026538
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
55591 Issued in CA
Practice address
7828 Haven Ave
Suite 102
Rancho Cucamonga, CA 91730-3049
Phone
(909) 257-4638
NPI assigned
Jan 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

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 55591 CA Primary

Addresses

Primary practice location

7828 Haven Ave
Suite 102
Rancho Cucamonga, CA 91730-3049

Mailing address

7828 Haven Ave
Suite 102
Rancho Cucamonga, CA 91730-3049
Phone (909) 257-4638

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
55591CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1327017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1497026538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7828 HAVEN AVE",
            "address_2": "SUITE 102",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303049",
            "telephone_number": "909-257-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7828 HAVEN AVE",
            "address_2": "SUITE 102",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303049",
            "telephone_number": "909-257-4638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVERNER",
        "first_name": "ALICIA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-20",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "55591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; 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.