Individual provider Active NPI

Lisa Craig, MFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1679709190
Registry record updated Jun 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC38482 Issued in CA
Practice address
2990 S Sepulveda Blvd
Suite 311
Los Angeles, CA 90064-0002
Phone
(310) 749-1066
NPI assigned
Jun 10, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2009

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 MFC38482 CA Primary

Addresses

Primary practice location

2990 S Sepulveda Blvd
Suite 311
Los Angeles, CA 90064-0002

Mailing address

2990 S Sepulveda Blvd
Suite 311
Los Angeles, CA 90064-0002
Phone (310) 749-1066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 18, 2024 through Mar 18, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC38482CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244592000000",
    "number": "1679709190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 S SEPULVEDA BLVD",
            "address_2": "SUITE 311",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900640002",
            "telephone_number": "310-749-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 S SEPULVEDA BLVD",
            "address_2": "SUITE 311",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900640002",
            "telephone_number": "310-749-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "LISA",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-10",
        "last_updated": "2009-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC38482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.