Individual provider Active NPI

Andrea Renee Dubon-Altamirano

  • Mental Health Counselor
  • Santa Clarita, CA
National Provider Identifier
1497307169
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
AMFT121553 Issued in CA
Practice address
27200 Tourney Rd Ste 175
Santa Clarita, CA 91355-4990
Phone
(661) 705-4670
NPI assigned
Jul 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 81910 CA
Mental Health Counselor 101YM0800X AMFT121553 CA Primary

Addresses

Primary practice location

27200 Tourney Rd Ste 175
Santa Clarita, CA 91355-4990

Mailing address

27200 Tourney Rd Ste 175
Santa Clarita, CA 91355-4990
Phone (661) 705-4670

Other practice location 1

21545 Centre Pointe Pkwy
Santa Clarita, CA 91350-2947
Phone (661) 259-9658

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
AMFT121553CAMDMental Health Counselor
81910CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
All for Kids Organization CurrentSince Dec 1, 2023 Accepting new patients

Locations

27200 Tourney Rd
Ste 175
Valencia, CA 91355
Phone (661) 705-4670

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": "1562889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1497307169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27200 TOURNEY RD STE 175",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913554990",
            "telephone_number": "661-705-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27200 TOURNEY RD STE 175",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913554990",
            "telephone_number": "661-705-4670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21545 Centre Pointe Pkwy",
            "address_purpose": "LOCATION",
            "city": "Santa Clarita",
            "state": "CA",
            "postal_code": "913502947",
            "country_code": "US",
            "telephone_number": "661-259-9658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBON-ALTAMIRANO",
        "first_name": "ANDREA",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-12",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "81910",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "AMFT121553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clarita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; 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.