Individual provider Active NPI

Lisa Anne Willmon, MFT

  • Marriage & Family Therapist
  • Pasadena, CA
National Provider Identifier
1851642565
Registry record updated Aug 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
28565 Issued in CA
Practice address
680 E Colorado Blvd Ste 180
Pasadena, CA 91101-6144
Phone
(646) 941-7645
Fax
(929) 596-7897
NPI assigned
Sep 21, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2024

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 28565 CA Primary

Addresses

Primary practice location

680 E Colorado Blvd Ste 180
Pasadena, CA 91101-6144

Mailing address

24712 Morning Star LN
Dana Point, CA 92629-1826
Phone (949) 371-6271

Other names 1

  • Miss Lisa Anne Livingston 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
I20240805001211 CA Practitioner - Marriage and Family Therapist 7416494794 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 22, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 22, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 22, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Willmon Family Counseling Services, Inc. Marriage & Family Therapist Past Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

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

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

Organizations & group practices 6

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": "1348185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723248000000",
    "number": "1851642565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24712 MORNING STAR LN",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926291826",
            "telephone_number": "949-371-6271",
            "fax_number": "951-684-4538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 E COLORADO BLVD STE 180",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911016144",
            "telephone_number": "646-941-7645",
            "fax_number": "929-596-7897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLMON",
        "first_name": "LISA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-21",
        "last_updated": "2024-08-10",
        "certification_date": "2024-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "28565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "LIVINGSTON",
            "middle_name": "ANNE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.