Individual provider Active NPI

Laylee G Davallou

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1902585664
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
138788 Issued in CA
Practice address
1200 Wilshire Blvd Ste 200
Los Angeles, CA 90017-1930
Phone
(121) 360-5269
NPI assigned
Jul 11, 2023
Last updated
Feb 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 138788 CA Primary

Addresses

Primary practice location

1200 Wilshire Blvd Ste 200
Los Angeles, CA 90017-1930

Mailing address

1200 Wilshire Blvd Ste 200
Los Angeles, CA 90017-1930
Phone (121) 360-5269

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

LicenseStateTypeSpecialty
138788CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Amanecer Community Counseling Service, a Non-Profit Corporation CurrentSince Jul 16, 2023 Accepting new patients
Amanecer Community Counseling Service, a Non-Profit Corporation PastSince Jul 16, 2023 Accepting new patients

Locations

1200 Wilshire Blvd
Ste 200
Los Angeles, CA 90017
Phone (213) 222-5035

Organizations & group practices 2

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": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1902585664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 WILSHIRE BLVD STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171930",
            "telephone_number": "121-360-5269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 WILSHIRE BLVD STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171930",
            "telephone_number": "121-360-5269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVALLOU",
        "first_name": "LAYLEE",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-11",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "138788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.