Individual provider Active NPI

Celia Avila

  • Marriage & Family Therapist
  • Hawaiian Gardens, CA
National Provider Identifier
1629467915
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT115993 Issued in CA
Practice address
21520 Pioneer Blvd
Suite 110
Hawaiian Gardens, CA 90716-2603
Phone
(562) 865-3644
NPI assigned
Jan 9, 2015
Last updated
Jan 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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 LMFT115993 CA Primary

Addresses

Primary practice location

21520 Pioneer Blvd
Suite 110
Hawaiian Gardens, CA 90716-2603

Mailing address

PO Box 951
Baldwin Park, CA 91706-0951
Phone (909) 620-2521

Other practice location 1

1511 W Garvey Ave N
West Covina, CA 91790-2138
Phone (626) 960-4844

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20240612002974 CA Practitioner - Marriage and Family Therapist 6406398817 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT115993CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Apr 30, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 30, 2024 Accepting new patients

Locations

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

1511 W Garvey Ave N
West Covina, CA 91790
Phone (626) 856-4820

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1629467915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 951",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917060951",
            "telephone_number": "909-620-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21520 PIONEER BLVD",
            "address_2": "SUITE 110",
            "city": "HAWAIIAN GARDENS",
            "state": "CA",
            "postal_code": "907162603",
            "telephone_number": "562-865-3644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1511 W Garvey Ave N",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917902138",
            "country_code": "US",
            "telephone_number": "626-960-4844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AVILA",
        "first_name": "CELIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-09",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT115993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1511 W Garvey Ave N",
            "city": "West Covina",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917902138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hawaiian Gardens, CA

Sources for this page

Verify at the official NPI Registry.