Individual provider Active NPI

Soraya Avalos

  • Marriage & Family Therapist
  • Santa Clarita, CA
National Provider Identifier
1588876346
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT86910 Issued in CA
Practice address
21545 Centre Pointe Pkwy
Santa Clarita, CA 91350-2947
Phone
(661) 244-7646
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT86910 CA Primary

Addresses

Primary practice location

21545 Centre Pointe Pkwy
Santa Clarita, CA 91350-2947

Mailing address

12166 Canyon Hill Ave
Sylmar, CA 91342-5496
Phone (661) 244-7646

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
I20240815000861 CA Practitioner - Marriage and Family Therapist 2264970763 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT86910CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 9, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 9, 2024 Accepting new patients
Child &Family Center Past Accepting new patients

Locations

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

Organizations & group practices 4

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1588876346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12166 CANYON HILL AVE",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913425496",
            "telephone_number": "661-244-7646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21545 CENTRE POINTE PKWY",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913502947",
            "telephone_number": "661-244-7646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVALOS",
        "first_name": "SORAYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT86910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clarita, CA

Sources for this page

Verify at the official NPI Registry.