Individual provider Active NPI

Michelle Theresa Oh

  • Marriage & Family Therapist
  • La Mirada, CA
National Provider Identifier
1679105563
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT107278 Issued in CA
Practice address
14241 Firestone Blvd Ste 400
La Mirada, CA 90638-5534
Phone
(714) 752-0559
NPI assigned
Feb 7, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X LMFT107278 CA Primary

Addresses

Primary practice location

14241 Firestone Blvd Ste 400
La Mirada, CA 90638-5534

Mailing address

13165 Briarwood St
Cerritos, CA 90703-7368
Phone (714) 752-0559

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
I20240629000117 CA Practitioner - Marriage and Family Therapist 6800330978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6 Centerpointe Dr
Suite 700
La Palma, CA 90623-2545
Phone (213) 331-7774

6281 Beach Blvd
Suite 304
Buena Park, CA 90621-4248
Phone (213) 331-7774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT107278CAMDMarriage & Family Therapist
107278CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Well Mental Health Counseling Licensed Clinical Social Worker Inc Single Specialty CurrentSince Jun 1, 2024 Accepting new patients

Locations

6281 Beach Blvd
Ste 304
Buena Park, CA 90621
Phone (213) 331-7774

6 Centerpointe Dr
Ste 700
La Palma, CA 90623
Phone (213) 331-7774

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1679105563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13165 BRIARWOOD ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907037368",
            "telephone_number": "714-752-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14241 FIRESTONE BLVD STE 400",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906385534",
            "telephone_number": "714-752-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OH",
        "first_name": "MICHELLE",
        "middle_name": "THERESA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT107278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mirada, CA

Sources for this page

Verify at the official NPI Registry.