Active NPI
Amy Van McMichael
- Marriage & Family Therapist
- Covina, CA
National Provider Identifier
1790311041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 53679
- Practice address
- 527 E Rowland St Ste 112
Covina, CA 91723-3230 - Phone
- (626) 428-7683
- NPI assigned
- Mar 18, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 53679 | CA | Primary |
Addresses
Primary practice location
527 E Rowland St Ste 112
Covina, CA 91723-3230
Mailing address
1820 Palopinto Ave
Glendora, CA 91741-3827
Phone (626) 354-7019
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 1, 2024 through Feb 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641600000000",
"number": "1790311041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1820 PALOPINTO AVE",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917413827",
"telephone_number": "626-354-7019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "527 E ROWLAND ST STE 112",
"city": "COVINA",
"state": "CA",
"postal_code": "917233230",
"telephone_number": "626-428-7683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMICHAEL",
"first_name": "AMY",
"middle_name": "VAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-18",
"last_updated": "2022-01-08",
"certification_date": "2022-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "53679",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.