Individual provider Active NPI

Gabriela Quintero, M.S MFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1699159764
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT124310 Issued in CA
Practice address
672 S la Fayette Park PL
Los Angeles, CA 90057-3251
Phone
(213) 381-3626
Fax
(213) 380-8923
NPI assigned
Jul 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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 LMFT124310 CA Primary

Addresses

Primary practice location

672 S la Fayette Park PL
Los Angeles, CA 90057-3251

Mailing address

4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone (310) 390-6612

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
I20240507001866 CA Practitioner - Marriage and Family Therapist 4385085471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

591 Camino de la Reina
Suite 802
San Diego, CA 92108-3110
Phone (858) 519-8002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LMFT124310CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vanessa Villasenor Licensed Marriage and Family Therapist Inc CurrentSince Mar 23, 2024 Accepting new patients

Locations

591 Camino de la Reina
Ste 802
San Diego, CA 92108
Phone (858) 208-0815

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": "1437091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1699159764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304820",
            "telephone_number": "310-390-6612",
            "fax_number": "310-398-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "672 S LA FAYETTE PARK PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573251",
            "telephone_number": "213-381-3626",
            "fax_number": "213-380-8923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTERO",
        "first_name": "GABRIELA",
        "credential": "M.S MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-17",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT124310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.