Individual provider Active NPI

Cassandra Taule Matukas

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1760029300
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
139479 Issued in CA
Practice address
6762 Lexington Ave
Los Angeles, CA 90038-1217
Phone
(323) 380-7590
NPI assigned
Dec 2, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Marriage & Family Therapist 106H00000X 139479 CA Primary

Addresses

Primary practice location

6762 Lexington Ave
Los Angeles, CA 90038-1217

Mailing address

6762 Lexington Ave
Los Angeles, CA 90038-1217
Phone (323) 380-7590

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

State licenses

LicenseStateTypeSpecialty
139479CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1760029300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6762 LEXINGTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900381217",
            "telephone_number": "323-380-7590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6762 LEXINGTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900381217",
            "telephone_number": "323-380-7590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATUKAS",
        "first_name": "CASSANDRA",
        "middle_name": "TAULE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "139479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.