Mylene Louise Carberry, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

103558 Issued in CA

Practice address

3145 S Canfield Ave
Apt. 11
Los Angeles, CA 90034-4368

Phone

(310) 621-1087

NPI assigned

Apr 3, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1548655772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3145 S CANFIELD AVE",
            "address_2": "APT. 11",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900344368",
            "telephone_number": "310-621-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 S CANFIELD AVE",
            "address_2": "APT. 11",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900344368",
            "telephone_number": "310-621-1087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBERRY",
        "first_name": "MYLENE",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-03",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF82472",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "103558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Carbajal
• Mark Anthony Carbajal, DENTAL ASSISTANT
• Ryan Carbajal
• Viviana Carbajal, FNP
• Alexandra N Carbayo
• Carbon Health Medical Group of California PC
• Carbon Health Medical Group of California PC
• Carbon Health Medical Group of California PC
• Guillermo Joel Carbon, MS, OTR/L
• Jude Andrew Carbon

• Marriage & Family Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.