Active NPI
Nikkolson Ngo Ang
- Marriage & Family Therapist
- Covina, CA
National Provider Identifier
1861076705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT162431
- Practice address
- 1126 N Grand Ave
Covina, CA 91724-1551 - Phone
- (626) 703-9627
- NPI assigned
- May 6, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LMFT162431 | CA | Primary |
| Marriage & Family Therapist | 106H00000X | AMFT136147 | CA | |
| Mental Health Counselor | 101YM0800X | AMFT136147 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Rehabilitation Practitioner | 225400000X |
Addresses
Primary practice location
1126 N Grand Ave
Covina, CA 91724-1551
Mailing address
PO Box 5442
West Covina, CA 91791-5442
Phone (626) 703-9627
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1126 N Grand Ave
Covina, CA 91724-1551
800 S Santa Anita Ave
Arcadia, CA 91006-3536
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AMFT136147 | CA | MD | Mental Health Counselor |
| LMFT162431 | CA | MD | Marriage & Family Therapist |
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
- Campbell, CA
- NPI 1255496105
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775001600000",
"number": "1861076705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5442",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917915442",
"telephone_number": "626-703-9627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1126 N GRAND AVE",
"city": "COVINA",
"state": "CA",
"postal_code": "917241551",
"telephone_number": "626-703-9627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANG",
"first_name": "NIKKOLSON",
"middle_name": "NGO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-05-06",
"last_updated": "2026-04-01",
"certification_date": "2026-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "LMFT162431",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "AMFT136147",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "AMFT136147",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.