Active NPI
Marty Craig Needleman, L.M.F.T.
- Marriage & Family Therapist
- Corona, CA
National Provider Identifier
1902002769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT 28206
- Practice address
- 2055 Kellogg Ave
Corona, CA 92879-3111 - Phone
- (951) 898-7119
- NPI assigned
- Jun 26, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFT 28206 | CA | Primary |
Addresses
Primary practice location
2055 Kellogg Ave
Corona, CA 92879-3111
Mailing address
5033 San Bernardino St.
Montclair, CA 92573-3111
Phone (909) 399-3767
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MFT28206 | Other | CA | LMFT NUMBER |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Kaiser Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT 28206 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639440000000",
"number": "1902002769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5033 SAN BERNARDINO ST.",
"city": "MONTCLAIR",
"state": "CA",
"postal_code": "925733111",
"telephone_number": "909-399-3767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2055 KELLOGG AVE",
"city": "CORONA",
"state": "CA",
"postal_code": "928793111",
"telephone_number": "951-898-7119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEEDLEMAN",
"first_name": "MARTY",
"middle_name": "CRAIG",
"name_prefix": "Mr.",
"credential": "L.M.F.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-26",
"last_updated": "2021-12-14",
"certification_date": "2021-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFT 28206",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LMFT NUMBER",
"identifier": "MFT28206",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Kaiser Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "5033 San Bernardino St",
"city": "Montclair",
"state": "CA",
"country_code": "US",
"postal_code": "91763",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Corona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.