Individual provider Active NPI

Michelle Lynn Horngren, M.S. LMFT

  • Marriage & Family Therapist
  • Diamond Bar, CA
National Provider Identifier
1770026791
Registry record updated Jul 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT113399 Issued in CA
Practice address
1058 Greycloud LN
Diamond Bar, CA 91765-4219
Phone
(909) 455-6996
NPI assigned
Nov 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMF#92306 CA
Marriage & Family Therapist 106H00000X LMFT113399 CA Primary

Addresses

Primary practice location

1058 Greycloud LN
Diamond Bar, CA 91765-4219

Mailing address

1058 Greycloud LN
Diamond Bar, CA 91765-4219
Phone (909) 455-6996

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
I20240903002133 CA Practitioner - Marriage and Family Therapist 2567901689 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
IMF#92306CAMDMarriage & Family Therapist
LMFT113399CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jun 16, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 16, 2024 Accepting new patients

Locations

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

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": "1479772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625443200000",
    "number": "1770026791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1058 GREYCLOUD LN",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917654219",
            "telephone_number": "909-455-6996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1058 GREYCLOUD LN",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917654219",
            "telephone_number": "909-455-6996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNGREN",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "M.S. LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-22",
        "last_updated": "2021-07-05",
        "certification_date": "2021-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF#92306",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT113399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamond Bar, CA

Sources for this page

Verify at the official NPI Registry.