Individual provider Active NPI

Monica Michelle Tiznado

  • Marriage & Family Therapist
  • Inglewood, CA
National Provider Identifier
1497895197
Registry record updated Oct 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
81074 Issued in CA
Practice address
323 N Prairie Ave
Inglewood, CA 90301-4502
Phone
(310) 846-2100
Fax
(310) 846-2139
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2014

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 81074 CA Primary

Addresses

Primary practice location

323 N Prairie Ave
Inglewood, CA 90301-4502

Mailing address

4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone (310) 390-6612

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
I20240212004409 CA Practitioner - Marriage and Family Therapist 6406999176 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
81074CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Healthcare CurrentSince May 10, 2024 Accepting new patients
Neighborhood Healthcare CurrentSince May 10, 2024 Accepting new patients
Koi Marriage and Family Therapy Current Accepting new patients
Neighborhood Healthcare Past Accepting new patients

Locations

855 E Madison Ave
El Cajon, CA 92020
Phone (619) 440-2751

425 N Date St
#0
Escondido, CA 92025

215 S Hickory St
Escondido, CA 92025
Phone (619) 354-3833

425 N Date St
Escondido, CA 92025
Phone (760) 737-2035

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414627200000",
    "number": "1497895197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304820",
            "telephone_number": "310-390-6612",
            "fax_number": "310-398-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 N PRAIRIE AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014502",
            "telephone_number": "310-846-2100",
            "fax_number": "310-846-2139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIZNADO",
        "first_name": "MONICA",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2014-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "81074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.