Individual provider Active NPI

Colleen Nicole Celaya

  • Marriage & Family Therapist
  • Glendale, CA
National Provider Identifier
1578857678
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMF103382 Issued in CA
Practice address
920 E Broadway
Glendale, CA 91205
Phone
(818) 247-7474
NPI assigned
Jun 6, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X
Marriage & Family Therapist 106H00000X IMF103382 CA Primary

Addresses

Primary practice location

920 E Broadway
Glendale, CA 91205

Mailing address

920 E Broadway
Glendale, CA 91205-1204
Phone (818) 247-7474

Other practice location 1

940 Avenue 64
Pasadena, CA 91105-2711
Phone (323) 254-2274

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
IMF103382CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1578857678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 E BROADWAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051204",
            "telephone_number": "818-247-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 E BROADWAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91205",
            "telephone_number": "818-247-7474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "940 Avenue 64",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911052711",
            "country_code": "US",
            "telephone_number": "323-254-2274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CELAYA",
        "first_name": "COLLEEN",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-06",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF103382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.