Active NPI
Mayra Yesenia Orellana
- Marriage & Family Therapist
- San Fernando, CA
National Provider Identifier
1801928916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMF78074
- Practice address
- 11565 Laurel Canyon Blvd Ste 1162ND
San Fernando, CA 91340-4168 - Phone
- (818) 361-5030
- Fax
- (818) 361-1764
- NPI assigned
- Mar 12, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | |||
| Marriage & Family Therapist | 106H00000X | IMF78074 | CA | Primary |
Addresses
Primary practice location
11565 Laurel Canyon Blvd Ste 1162ND
San Fernando, CA 91340-4168
Mailing address
13361 Wentworth St
Arleta, CA 91331-6346
Phone (818) 787-0988
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
| License | State | Type | Specialty |
|---|---|---|---|
| IMF78074 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510531200000",
"number": "1801928916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13361 WENTWORTH ST",
"city": "ARLETA",
"state": "CA",
"postal_code": "913316346",
"telephone_number": "818-787-0988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11565 LAUREL CANYON BLVD STE 1162ND",
"city": "SAN FERNANDO",
"state": "CA",
"postal_code": "913404168",
"telephone_number": "818-361-5030",
"fax_number": "818-361-1764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORELLANA",
"first_name": "MAYRA",
"middle_name": "YESENIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-12",
"last_updated": "2017-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF78074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Fernando, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.