Individual provider Active NPI

Alexus Lan Ngo-Agard, MS

  • Marriage & Family Therapist
  • Lodi, CA
National Provider Identifier
1497884860
Registry record updated Sep 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
74135 Issued in CA
Practice address
12755 N Highway 88
Lodi, CA 95240-9323
Phone
(209) 340-5800
NPI assigned
Mar 3, 2007
Last updated
Sep 6, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2013

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 74135 CA Primary

Addresses

Primary practice location

12755 N Highway 88
Lodi, CA 95240-9323

Mailing address

3300 Renwick Ave Unit 2002
Elk Grove, CA 95758-7493
Phone (916) 686-1412

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
I20240229003506 CA Practitioner - Marriage and Family Therapist 0648615674 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
74135CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Cyti Health PC CurrentSince Jan 17, 2024 Accepting new patients
Victor Treatment Centers, Inc. Past Accepting new patients

Locations

11801 Pierce St
Riverside, CA 92505
Phone (909) 528-0317

3111 Camino del Rio N
Ste 460
San Diego, CA 92108

402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1497884860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 RENWICK AVE UNIT 2002",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587493",
            "telephone_number": "916-686-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12755 N HIGHWAY 88",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952409323",
            "telephone_number": "209-340-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO-AGARD",
        "first_name": "ALEXUS",
        "middle_name": "LAN",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-03",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "74135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

Verify at the official NPI Registry.