Roy Dror
Individual provider Active NPI Marriage & Family Therapist · Sylmar, CA
NPI 1679700488 · NPPES record last updated Nov 24, 2021
Key facts
- NPI
- 1679700488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- Practice address
- 12669 Encinitas Ave
Sylmar, CA 91342-3635 - Phone
- (800) 700-8705
- NPI assigned
- Jun 18, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240717002725 | CA | Practitioner - Marriage and Family Therapist | 8426593161 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 78349 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Act Family Counseling Incorporated | Marriage & Family Therapist | Past | Accepting new patients |
Locations
4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784
393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914
12669 Encinitas Ave
Sylmar, CA 91342
Phone (800) 700-8705
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 78349 | CA | |
| Marriage & Family Therapist | 106H00000X | CA | Yes |
Addresses
Primary practice location
12669 Encinitas Ave
Sylmar, CA 91342-3635
Mailing address
12669 Encinitas Ave
Sylmar, CA 91342-3635
Phone (800) 700-8705
Other practice location 1
2545 S Euclid Ave
Ontario, CA 91762-6620
Phone (983) 909-5575
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Other | Kaiser Permanente |
Other providers in Sylmar, CA
- Suzanne Donovan
- Ann Doqui
- Lorenzo Dorado
- Dr. Leonard H. Forbes, O.D.
- Peter Drocton
- Dubnoff Center
- William Dubon
- Tavit J Dunnsiri
- Thuy Thi Duong
- Tyler Marie Duvernay
All providers in Sylmar, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 24, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.