Active NPI
Susana Prego
- Marriage & Family Therapist
- Long Beach, CA
National Provider Identifier
1902170467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 90554
- Practice address
- 1301 Pine Ave
Long Beach, CA 90813 - Phone
- (562) 216-2338
- Fax
- (562) 426-4661
- NPI assigned
- Mar 1, 2012
- Sex
- Female
- Sole proprietor
- No
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 | 90554 | CA | Primary |
Addresses
Primary practice location
1301 Pine Ave
Long Beach, CA 90813
Mailing address
1301 Pine Ave
Long Beach, CA 90813-3124
Phone (562) 216-2338
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240423002714 | CA | Practitioner - Marriage and Family Therapist | 0042659062 | Practice locations: Long Beach, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539648000000",
"number": "1902170467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 PINE AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908133124",
"telephone_number": "562-216-2338",
"fax_number": "562-426-4661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 PINE AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90813",
"telephone_number": "562-216-2338",
"fax_number": "562-426-4661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PREGO",
"first_name": "SUSANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-01",
"last_updated": "2018-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "90554",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.