Individual provider Active NPI

Thali Silva Rodrigues Costa

  • Marriage & Family Therapist
  • Van Nuys, CA
National Provider Identifier
1912555343
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
130054 Issued in CA
Practice address
16360 Roscoe Blvd Ste 200
Van Nuys, CA 91406-1213
Phone
(818) 901-4830
NPI assigned
Aug 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 98414 CA
Marriage & Family Therapist 106H00000X 130054 CA Primary

Addresses

Primary practice location

16360 Roscoe Blvd Ste 200
Van Nuys, CA 91406-1213

Mailing address

6460 Mammoth Ave Apt 210
Van Nuys, CA 91401-1529

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
130054CAMDMarriage & Family Therapist
98414CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1912555343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6460 MAMMOTH AVE APT 210",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914011529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16360 ROSCOE BLVD STE 200",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914061213",
            "telephone_number": "818-901-4830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILVA RODRIGUES COSTA",
        "first_name": "THALI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "98414",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "130054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.