Active NPI
Charles Edgar Bastedo, MFCT
- Marriage & Family Therapist
- Long Beach, CA
National Provider Identifier
1912046038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 15096
- Practice address
- 5199 E Pacific Coast Hwy
Suite 504
Long Beach, CA 90804-3371 - Phone
- (562) 498-1750
- Fax
- (562) 498-7463
- NPI assigned
- Feb 5, 2007
- Sex
- Male
- 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 | 15096 | CA | Primary |
Addresses
Primary practice location
5199 E Pacific Coast Hwy
Suite 504
Long Beach, CA 90804-3371
Mailing address
5199 E Pacific Coast Hwy
Suite 504
Long Beach, CA 90804-3371
Phone (562) 498-1750
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Aug 8, 2024 through Aug 8, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15096 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bastedo Psychological Inc | Marriage & Family Therapist | Past | Accepting new patients |
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.
-
dba Coast Counseling Services
- Marriage & Family Therapist
- Long Beach, CA
- NPI 1568589737
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912046038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5199 E PACIFIC COAST HWY",
"address_2": "SUITE 504",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908043371",
"telephone_number": "562-498-1750",
"fax_number": "562-498-7463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5199 E PACIFIC COAST HWY",
"address_2": "SUITE 504",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908043371",
"telephone_number": "562-498-1750",
"fax_number": "562-498-7463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASTEDO",
"first_name": "CHARLES",
"middle_name": "EDGAR",
"name_prefix": "Mr.",
"credential": "MFCT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "15096",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.