Individual provider Active NPI

Stephanie Lizette Herrera, LMFT

  • Marriage & Family Therapist
  • Long Beach, CA
National Provider Identifier
1578025219
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
151782 Issued in CA
Practice address
5190 Atlantic Ave
Long Beach, CA 90805-6510
Phone
(562) 428-4111
NPI assigned
Apr 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X
Case Manager/Care Coordinator 171M00000X
Marriage & Family Therapist 106H00000X 151782 CA Primary

Addresses

Primary practice location

5190 Atlantic Ave
Long Beach, CA 90805-6510

Mailing address

12635 Harris Ave
Lynwood, CA 90262-5216
Phone (310) 909-9256

Other practice location 1

3630 E Imperial Hwy
Lynwood, CA 90262-2609
Phone (310) 909-9256

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
I20250214001065 CA Practitioner - Marriage and Family Therapist 8426588807 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
151782CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tarzana Treatment Centers, Inc. CurrentSince Dec 3, 2024 Accepting new patients
Tarzana Treatment Centers, Inc. Case Manager/Care Coordinator Current Accepting new patients
Tarzana Treatment Centers, Inc. CurrentSince Dec 3, 2024 Accepting new patients

Locations

5190 Atlantic Ave
Long Beach, CA 90805
Phone (562) 428-4111

18646 Oxnard St
Tarzana, CA 91356
Phone (818) 654-3815

Organizations & group practices 3

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": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1578025219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12635 HARRIS AVE",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902625216",
            "telephone_number": "310-909-9256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5190 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908056510",
            "telephone_number": "562-428-4111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3630 E Imperial Hwy",
            "address_purpose": "LOCATION",
            "city": "Lynwood",
            "state": "CA",
            "postal_code": "902622609",
            "country_code": "US",
            "telephone_number": "310-909-9256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "STEPHANIE",
        "middle_name": "LIZETTE",
        "name_prefix": "Miss",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "151782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.