Matreeporn Puangbanyen

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1775 Chestnut Ave
Long Beach, CA 90813

Phone

(562) 599-8444

NPI assigned

Feb 5, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Behavioral Health Services Inc.

  • Substance Abuse Rehabilitation Facility
  • Long Beach, CA
  • NPI 1134259088
  NPD (past)

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

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1578895256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 CHESTNUT AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908131674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 CHESTNUT AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90813",
            "telephone_number": "562-599-8444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12440 Firestone Blvd",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CA",
            "postal_code": "906504328",
            "country_code": "US",
            "telephone_number": "562-929-6688 x103",
            "fax_number": "562-929-3868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUANGBANYEN",
        "first_name": "MATREEPORN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-05",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Psych Lab Psychology, Inc.
• Psychatric Services, MD
• Psychshield Corporation
• Pt4Tots, a Professional Physical Therapy Corporation
• Yuka Pu
• Estephany Fabiola Puccio Colindres
• Alice Puentes
• Nancy Puentes
• Jane Nathalie Puerto
• Maria Marcia Puerto

• Counselor in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.