Individual provider Active NPI

Nancy E Salvatierra, LMFT125964

  • Marriage & Family Therapist
  • Panorama City, CA
National Provider Identifier
1699213488
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
125964 Issued in CA
Practice address
14500 Roscoe Blvd Ste 400
Panorama City, CA 91402-4194
Phone
(626) 671-3244
NPI assigned
Feb 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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 125964 CA Primary

Addresses

Primary practice location

14500 Roscoe Blvd Ste 400
Panorama City, CA 91402-4194

Mailing address

14500 Roscoe Blvd Ste 400
Panorama City, CA 91402-4194
Phone (800) 764-8981

Other names 1

  • Mrs. Nancy E Dominguez Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20240513000604 CA Practitioner - Marriage and Family Therapist 2365883030 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125964CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 14, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 14, 2024 Accepting new patients
Shine Medical of Ca PC Past Accepting new patients

Locations

43112 15th St W
Lancaster, CA 93534
Phone (661) 726-2222

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

Organizations & group practices 4

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": "1485907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1699213488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14500 ROSCOE BLVD STE 400",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914024194",
            "telephone_number": "800-764-8981",
            "fax_number": "818-935-6189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14500 ROSCOE BLVD STE 400",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914024194",
            "telephone_number": "626-671-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALVATIERRA",
        "first_name": "NANCY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "LMFT125964",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-01",
        "last_updated": "2024-12-30",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "125964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "43112 15th St W",
            "city": "Lancaster",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935346219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "DOMINGUEZ",
            "middle_name": "E",
            "prefix": "MRS.",
            "credential": "NANCY E. DOMINGUEZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Panorama City, CA

Sources for this page

Verify at the official NPI Registry.