Individual provider Active NPI

Laura Margarita Landaverde

  • Marriage & Family Therapist
  • Colton, CA
National Provider Identifier
1518578970
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
163292 Issued in CA
Practice address
1330 E Cooley Dr # 92324
Colton, CA 92324-3905
Phone
(909) 580-3728
NPI assigned
Aug 10, 2020
Reactivated
May 12, 2022
Last updated
May 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

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 163292 CA Primary

Addresses

Primary practice location

1330 E Cooley Dr # 92324
Colton, CA 92324-3905

Mailing address

1950 S Sunwest LN Ste 200
San Bernardino, CA 92408-3248
Phone (909) 252-4017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19322 Jesse LN
Suite 200
Riverside, CA 92508-5072

2730 Wrangler Cir
Corona, CA 92882-6809

500 W Jefferson St
Louisville, KY 40202-2881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
163292CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1518578970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 S SUNWEST LN STE 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083248",
            "telephone_number": "909-252-4017",
            "fax_number": "818-241-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 E COOLEY DR # 92324",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923243905",
            "telephone_number": "909-580-3728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDAVERDE",
        "first_name": "LAURA",
        "middle_name": "MARGARITA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "deactivation_date": "2022-04-19",
        "reactivation_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "163292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.