Active NPI
Wendy Lynn Fraser de Augustine, MFT INTERN
- Rehabilitation Practitioner
- Mission Hills, CA
National Provider Identifier
1679871552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 11565 Laurel Canyon
# 116
Mission Hills, CA 91345 - Phone
- (818) 361-5030
- NPI assigned
- Mar 2, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | Primary |
Addresses
Primary practice location
11565 Laurel Canyon
# 116
Mission Hills, CA 91345
Mailing address
11565 Laurel Canyon
# 114
Mission Hills, CA 91345
Phone (818) 361-5030
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370822400000",
"number": "1679871552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11565 LAUREL CANYON",
"address_2": "# 114",
"city": "MISSION HILLS",
"state": "CA",
"postal_code": "91345",
"telephone_number": "818-361-5030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11565 LAUREL CANYON",
"address_2": "# 116",
"city": "MISSION HILLS",
"state": "CA",
"postal_code": "91345",
"telephone_number": "818-361-5030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRASER DE AUGUSTINE",
"first_name": "WENDY",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "MFT INTERN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-02",
"last_updated": "2013-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mission Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.