Individual provider Active NPI

Lorraine Rose Iocolano, LMFT

  • Marriage & Family Therapist
  • San Pedro, CA
National Provider Identifier
1881115244
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
125786 Issued in CA
Practice address
1891 N Gaffey St Ste I
San Pedro, CA 90731-1268
Phone
(424) 264-5288
Fax
(310) 634-0370
NPI assigned
Jul 6, 2017
Last updated
Dec 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 108809 CA
Marriage & Family Therapist 106H00000X 108809 CA
Marriage & Family Therapist 106H00000X 125786 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU
Rehabilitation Practitioner 225400000X NU

Addresses

Primary practice location

1891 N Gaffey St Ste I
San Pedro, CA 90731-1268

Mailing address

1891 N Gaffey St Ste I
San Pedro, CA 90731-1268
Phone (424) 264-5288

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
I20250428003093 CA Practitioner - Marriage and Family Therapist 8820514318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1891 N Gaffey St
Suite I
San Pedro, CA 90731-1268
Phone (424) 264-5288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
108809CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Windfall Family Therapy Prof Corp Marriage & Family Therapist CurrentSince Mar 8, 2025 Accepting new patients

Locations

1891 N Gaffey St
Ste I
San Pedro, CA 90731
Phone (424) 264-5288

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1881115244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1891 N GAFFEY ST STE I",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907311268",
            "telephone_number": "424-264-5288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1891 N GAFFEY ST STE I",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907311268",
            "telephone_number": "424-264-5288",
            "fax_number": "310-634-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IOCOLANO",
        "first_name": "LORRAINE",
        "middle_name": "ROSE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-06",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "108809",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "108809",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "125786",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

Verify at the official NPI Registry.