Individual provider Active NPI

Nikkolson Ngo Ang

  • Marriage & Family Therapist
  • Covina, CA
National Provider Identifier
1861076705
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT162431 Issued in CA
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

Updated by the provider on Apr 1, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260518002764 CA Practitioner - Marriage and Family Therapist 0941779086 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
AMFT136147CAMDMental Health Counselor
LMFT162431CAMDMarriage & 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.

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

Verify at the official NPI Registry.