Organization Active NPI

Dialogs With Life a Medical Corporation

  • Marriage & Family Therapist
  • Pasadena, CA
National Provider Identifier
1508344235
Registry record updated Aug 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
102496 Issued in CA
Legal business name
DIALOGS WITH LIFE A MEDICAL CORPORATION
Practice address
1055 E Colorado Blvd Ste 5190
Pasadena, CA 91106-2327
Phone
(213) 373-1938
Fax
(213) 226-0556
NPI assigned
Aug 3, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2018

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

Authorized official

Name
Mr. Bernard Martin Douglas, LMFTNPI 1881077485
Title
President
Phone
(213) 373-1938

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X 102496 CA Primary

Addresses

Primary practice location

1055 E Colorado Blvd Ste 5190
Pasadena, CA 91106-2327

Mailing address

465 S Hudson Ave Apt 1
Pasadena, CA 91101-5007
Phone (213) 373-1938

Other practice location 1

6535 Wilshire Blvd Ste 103
Los Angeles, CA 90048-4962
Phone (213) 373-1938

Other identifiers 1

IdentifierTypeStateIssuer
102496OtherCAMARRIAGE & FAMILY THERAPIST

National Provider Directory

National Provider Directory

Locations

1055 E Colorado Blvd
Ste 5190
Pasadena, CA 91106
Phone (213) 373-1938

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1533254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533254400000",
    "number": "1508344235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 S HUDSON AVE APT 1",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911015007",
            "telephone_number": "213-373-1938",
            "fax_number": "213-226-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 E COLORADO BLVD STE 5190",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911062327",
            "telephone_number": "213-373-1938",
            "fax_number": "213-226-0556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6535 Wilshire Blvd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900484962",
            "country_code": "US",
            "telephone_number": "213-373-1938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DIALOGS WITH LIFE A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-03",
        "last_updated": "2018-08-03",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-373-1938",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "102496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARRIAGE & FAMILY THERAPIST",
            "identifier": "102496",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2018; 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.