Matthew David Stephan, AMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMF99654 Issued in CA

Practice address

14660 Oxnard St
Van Nuys, CA 91411

Phone

(818) 901-4836

NPI assigned

May 12, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1526083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1841780194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14660 OXNARD ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914113119",
            "telephone_number": "818-901-4836",
            "fax_number": "818-376-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14660 OXNARD ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "91411",
            "telephone_number": "818-901-4836"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18321 Ventura Blvd Ste 515",
            "address_purpose": "LOCATION",
            "city": "Tarzana",
            "state": "CA",
            "postal_code": "913564248",
            "country_code": "US",
            "telephone_number": "818-850-3662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHAN",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-12",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF99654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.