Individual provider Active NPI

Norma Elizabeth Ixcol, LMFT111212

  • Marriage & Family Therapist
  • Riverside, CA
National Provider Identifier
1811550858
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT111212 Issued in CA
Practice address
7177 Brockton Ave Ste 111
Riverside, CA 92506-2632
Phone
(433) 788-8795
Fax
(949) 460-5322
NPI assigned
Apr 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X LMFT111212 CA Primary

Addresses

Primary practice location

7177 Brockton Ave Ste 111
Riverside, CA 92506-2632

Mailing address

7177 Brockton Ave Ste 111
Riverside, CA 92506-2632
Phone (433) 788-8795

Other names 1

  • Norma Elizabeth Urquidez Former name

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
I20240618002077 CA Practitioner - Marriage and Family Therapist 1355884495 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT111212CAMDMarriage & Family Therapist
111212CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Center for New Directions, Inc. Single Specialty CurrentSince Apr 20, 2024 Accepting new patients
Stephen M Pumphrey Licensed Clinical Social Workers Inc Single Specialty PastSince Dec 25, 2018 Accepting new patients

Locations

23201 Mill Creek Dr
Ste 220
Laguna Hills, CA 92653
Phone (949) 460-5320

7177 Brockton Ave
Ste 111
Riverside, CA 92506
Phone (949) 460-5322

232 W Main St
Ste 101
Tustin, CA 92780
Phone (714) 478-9431

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": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1811550858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7177 BROCKTON AVE STE 111",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062632",
            "telephone_number": "433-788-8795",
            "fax_number": "949-460-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7177 BROCKTON AVE STE 111",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062632",
            "telephone_number": "433-788-8795",
            "fax_number": "949-460-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IXCOL",
        "first_name": "NORMA",
        "middle_name": "ELIZABETH",
        "credential": "LMFT111212",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT111212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NORMA",
            "last_name": "URQUIDEZ",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.