Individual provider Active NPI

Alma Y. Baeza, LMFT

  • Marriage & Family Therapist
  • Moreno Valley, CA
National Provider Identifier
1861054645
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
113968 Issued in CA
Practice address
12815 Heacock St
Moreno Valley, CA 92553-3116
Phone
(951) 601-6174
NPI assigned
Jul 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 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 Therapist 106H00000X 113968 CA Primary

Addresses

Primary practice location

12815 Heacock St
Moreno Valley, CA 92553-3116

Mailing address

PO Box 101
Redlands, CA 92373-0041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
113968CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince May 27, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince May 27, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

12815 Heacock St
Moreno Valley, CA 92553
Phone (951) 601-6174

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

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

Organizations & group practices 3

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": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1861054645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 101",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923730041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12815 HEACOCK ST",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533116",
            "telephone_number": "951-601-6174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAEZA",
        "first_name": "ALMA",
        "middle_name": "Y.",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "113968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.