Individual provider Active NPI

Edgar J Cervantes, LMFT

  • Marriage & Family Therapist
  • Riverside, CA
National Provider Identifier
1619505088
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
109185 Issued in CA
Practice address
6800 Indiana Ave Ste 130
Riverside, CA 92506-4266
Phone
(323) 273-6886
NPI assigned
Mar 31, 2020
Last updated
Nov 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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 109185 CA Primary

Addresses

Primary practice location

6800 Indiana Ave Ste 130
Riverside, CA 92506-4266

Mailing address

9825 Magnolia Ave Ste B
Riverside, CA 92503-3565
Phone (951) 509-2499

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
109185CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1619505088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9825 MAGNOLIA AVE STE B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033565",
            "telephone_number": "951-509-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 INDIANA AVE STE 130",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064266",
            "telephone_number": "323-273-6886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERVANTES",
        "first_name": "EDGAR",
        "middle_name": "J",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-31",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "109185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.