Individual provider Active NPI

James Malinda III, L.M.F.T.

  • Marriage & Family Therapist
  • Sylmar, CA
National Provider Identifier
1811303704
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT30193 Issued in CA
Practice address
12669 Encinitas Ave
Sylmar, CA 91342-3635
Phone
(800) 700-8705
NPI assigned
Jul 11, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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 LMFT30193 CA Primary

Addresses

Primary practice location

12669 Encinitas Ave
Sylmar, CA 91342-3635

Mailing address

12669 Encinitas Ave
Sylmar, CA 91342-3635
Phone (800) 700-8705

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240903000906 CA Practitioner - Marriage and Family Therapist 1355880550 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT30193CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jun 20, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

12669 Encinitas Ave
Sylmar, CA 91342
Phone (800) 700-8705

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1811303704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12669 ENCINITAS AVE",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913423635",
            "telephone_number": "800-700-8705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12669 ENCINITAS AVE",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913423635",
            "telephone_number": "800-700-8705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALINDA",
        "first_name": "JAMES",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "L.M.F.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-11",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT30193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "12669 Encinitas Ave",
            "city": "Sylmar",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913423635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

Verify at the official NPI Registry.