Monica Poulsen

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMF70946 Issued in CA

Practice address

780 E Gilbert St
San Bernardino, CA 92415-1003

Phone

(909) 763-4760

Fax

(909) 763-4771

NPI assigned

Sep 10, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Marriage and Family Therapist

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Family Talk Therapy Center

  • Marriage & Family Therapist
  • Riverside, CA
  • NPI 1174089411
  Medicare reassignment NPD

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378771200000",
    "number": "1770918658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 E GILBERT ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924151003",
            "telephone_number": "909-763-4760",
            "fax_number": "909-763-4771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 E GILBERT ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924151003",
            "telephone_number": "909-763-4760",
            "fax_number": "909-763-4771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULSEN",
        "first_name": "MONICA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-10",
        "last_updated": "2013-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF70946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryjane Porcho
• Kemara Farchasia Porter
• Christopher Post, DVM
• Todd Benjamin Potter
• Shayne Poulin, M.D.
• Pourshirazi & Sareh Dental Corp
• Ved Prakash, M.D,
• Joshua Jaime Praslin
• Laura Preciado
• Precious Life Clinics-Ces

• Marriage & Family Therapist in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.