Individual provider Active NPI

Michele Teitelbaum, M.F.T.

  • Marriage & Family Therapist
  • Hermosa Beach, CA
National Provider Identifier
1790879286
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
35166 Issued in CA
Practice address
2615 Pacific Coast Hwy #217
Hermosa Beach, CA 90254
Phone
(310) 372-4892
Fax
(310) 372-4892
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 35166 CA Primary

Addresses

Primary practice location

2615 Pacific Coast Hwy #217
Hermosa Beach, CA 90254

Mailing address

501 Herondo St. #32
Hermosa Beach, CA 90254
Phone (310) 372-4892

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
35166CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790879286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 HERONDO ST. #32",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "90254",
            "telephone_number": "310-372-4892",
            "fax_number": "310-372-4892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 PACIFIC COAST HWY #217",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "90254",
            "telephone_number": "310-372-4892",
            "fax_number": "310-372-4892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEITELBAUM",
        "first_name": "MICHELE",
        "name_prefix": "Ms.",
        "credential": "M.F.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "35166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermosa Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.