Individual provider Active NPI

Cristina L. Dawes, LMFT

  • Mental Health Counselor
  • San Pedro, CA
National Provider Identifier
1558554162
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MFC45948 Issued in CA
Practice address
2500 Via Cabrillo Mrna Ste 200A1
San Pedro, CA 90731-7224
Phone
(424) 287-9762
Fax
(310) 507-0145
NPI assigned
Aug 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X MFC45948 CA Primary

Addresses

Primary practice location

2500 Via Cabrillo Mrna Ste 200A1
San Pedro, CA 90731-7224

Mailing address

28625 S Western Ave Unit 123
Rancho Palos Verdes, CA 90275-0810
Phone (424) 287-9762

Other practice location 1

222 W 6th St
Suite 400
San Pedro, CA 90731-3316
Phone (424) 287-9762

Other identifiers 1

IdentifierTypeStateIssuer
1558554162MedicaidCA

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC45948CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1558554162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28625 S WESTERN AVE UNIT 123",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902750810",
            "telephone_number": "424-287-9762",
            "fax_number": "424-400-5648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 VIA CABRILLO MRNA STE 200A1",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907317224",
            "telephone_number": "424-287-9762",
            "fax_number": "310-507-0145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 W 6th St",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "San Pedro",
            "state": "CA",
            "postal_code": "907313316",
            "country_code": "US",
            "telephone_number": "424-287-9762",
            "fax_number": "424-400-5648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAWES",
        "first_name": "CRISTINA",
        "middle_name": "L.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-27",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFC45948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558554162",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; 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.