Individual provider Active NPI

Mayra Yesenia Orellana

  • Marriage & Family Therapist
  • San Fernando, CA
National Provider Identifier
1801928916
Registry record updated Nov 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMF78074 Issued in CA
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

Updated by the provider on Nov 13, 2017

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
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

LicenseStateTypeSpecialty
IMF78074CAMDMarriage & 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.

Verify at the official NPI Registry.