Active NPI
Larynda Lynn Peterson, LMFT
- Marriage & Family Therapist
- La Verne, CA
National Provider Identifier
1821679622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 115124
- Practice address
- 2120 Foothill Blvd Ste 213
La Verne, CA 91750-2950 - Phone
- (909) 575-8184
- NPI assigned
- Apr 14, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 115124 | CA | Primary |
Addresses
Primary practice location
2120 Foothill Blvd Ste 213
La Verne, CA 91750-2950
Mailing address
3355 N White Ave # 253
La Verne, CA 91750-6112
Phone (626) 253-8899
Other names 1
- Larynda Lynn Peterson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 26, 2024 through Feb 26, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115124 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618358400000",
"number": "1821679622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3355 N WHITE AVE # 253",
"city": "LA VERNE",
"state": "CA",
"postal_code": "917506112",
"telephone_number": "626-253-8899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2120 FOOTHILL BLVD STE 213",
"city": "LA VERNE",
"state": "CA",
"postal_code": "917502950",
"telephone_number": "909-575-8184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "LARYNDA",
"middle_name": "LYNN",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-14",
"last_updated": "2021-04-14",
"certification_date": "2021-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "115124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LARYNDA",
"last_name": "PETERSON",
"middle_name": "LYNN",
"credential": "LMFT",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in La Verne, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.