Individual provider Active NPI

Gabrielle Livingston Banta

  • Marriage & Family Therapist
  • Long Beach, CA
National Provider Identifier
1700670676
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
139157 Issued in CA
Practice address
2009 Palo Verde Ave
Long Beach, CA 90815-3322
Phone
(562) 794-7008
Fax
(562) 632-5192
NPI assigned
Apr 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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 139157 CA Primary

Addresses

Primary practice location

2009 Palo Verde Ave
Long Beach, CA 90815-3322

Mailing address

2009 Palo Verde Ave
Long Beach, CA 90815-3322
Phone (562) 794-7008

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

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Life Solutions, a Couples and Family Therapy Corporation Marriage & Family Therapist CurrentSince Apr 13, 2025 Accepting new patients
New Wave Youth and Family Therapy Services Marriage & Family Therapist CurrentSince Apr 13, 2025 Accepting new patients

Locations

2009 Palo Verde Ave
Long Beach, CA 90815
Phone (562) 743-2389

Organizations & group practices 2

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": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1700670676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2009 PALO VERDE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908153322",
            "telephone_number": "562-794-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 PALO VERDE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908153322",
            "telephone_number": "562-794-7008",
            "fax_number": "562-632-5192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANTA",
        "first_name": "GABRIELLE",
        "middle_name": "LIVINGSTON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "139157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.