Active NPI
Marycollette Ukattah
- Marriage & Family Therapist
- Los Angeles, CA
National Provider Identifier
1821505546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 122798
- Practice address
- 11601 S Western Ave
Los Angeles, CA 90047-5006 - Phone
- (323) 242-5000
- NPI assigned
- Jan 3, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF98671 | CA | |
| Marriage & Family Therapist | 106H00000X | AMFT98671 | CA | |
| Marriage & Family Therapist | 106H00000X | 122798 | CA | Primary |
Addresses
Primary practice location
11601 S Western Ave
Los Angeles, CA 90047-5006
Mailing address
11601 S Western Ave
Los Angeles, CA 90047-5006
Phone (323) 242-5000
Other practice location 1
2116 Arlington Ave
Los Angeles, CA 90018-1353
Phone (310) 264-6646
Other practice location 2
2248 Obispo Ave Ste 202
Signal Hill, CA 90755
Phone (213) 550-2634 ext. 5401
Other practice location 3
161 W Victoria St
Long Beach, CA 90805-2175
Phone (323) 242-5000
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 |
|---|---|---|---|
| AMFT98671 | CA | MD | Marriage & Family Therapist |
| IMF98671 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aspiranet | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Signal Hill, CA
- NPI 1881143154
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620345600000",
"number": "1821505546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11601 S WESTERN AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900475006",
"telephone_number": "323-242-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11601 S WESTERN AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900475006",
"telephone_number": "323-242-5000"
}
],
"practiceLocations": [
{
"address_1": "2116 Arlington Ave",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900181353",
"country_code": "US",
"telephone_number": "310-264-6646",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2248 Obispo Ave Ste 202",
"address_purpose": "LOCATION",
"city": "Signal Hill",
"state": "CA",
"postal_code": "90755",
"country_code": "US",
"telephone_number": "213-550-2634 x5401",
"fax_number": "562-494-3748",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "161 W Victoria St",
"address_purpose": "LOCATION",
"city": "Long Beach",
"state": "CA",
"postal_code": "908052175",
"country_code": "US",
"telephone_number": "323-242-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "UKATTAH",
"first_name": "MARYCOLLETTE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-03",
"last_updated": "2021-05-07",
"certification_date": "2021-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF98671",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "AMFT98671",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "122798",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.