Individual provider Active NPI

Emmanuel Velasco

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1619646841
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
153361 Issued in CA
Practice address
2001 S Barrington Ave Ste 204
Los Angeles, CA 90025-5385
Phone
(310) 902-0990
NPI assigned
Sep 10, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Marriage & Family Therapist 106H00000X 153361 CA Primary

Addresses

Primary practice location

2001 S Barrington Ave Ste 204
Los Angeles, CA 90025-5385

Mailing address

711 Colorado Ave
Palo Alto, CA 94303-3912
Phone (650) 938-3600

Other practice location 1

711 Colorado Ave
Palo Alto, CA 94303-3912
Phone (650) 938-3600

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
153361CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Learning Consultants, Inc. Marriage & Family Therapist CurrentSince Sep 1, 2021 Accepting new patients

Locations

711 Colorado Ave
Palo Alto, CA 94303
Phone (650) 291-9325

Organizations & group practices 1

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": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1619646841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 COLORADO AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943033912",
            "telephone_number": "650-938-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S BARRINGTON AVE STE 204",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255385",
            "telephone_number": "310-902-0990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 Colorado Ave",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943033912",
            "country_code": "US",
            "telephone_number": "650-938-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VELASCO",
        "first_name": "EMMANUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-10",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "153361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; 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.