Active NPI
Mary Delucia, MA, MFT
- Marriage & Family Therapist
- Los Angeles, CA
National Provider Identifier
1922596089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 103961
- Practice address
- 11500 W Olympic Blvd Ste 500
Los Angeles, CA 90064-1569 - Phone
- (310) 922-9319
- NPI assigned
- Apr 24, 2018
- Sex
- Female
- 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 | 103961 | CA | Primary |
Addresses
Primary practice location
11500 W Olympic Blvd Ste 500
Los Angeles, CA 90064-1569
Mailing address
630 Idaho Ave Apt 301
Santa Monica, CA 90403-2758
Phone (310) 922-9319
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103961 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1922596089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 IDAHO AVE APT 301",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904032758",
"telephone_number": "310-922-9319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11500 W OLYMPIC BLVD STE 500",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900641569",
"telephone_number": "310-922-9319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELUCIA",
"first_name": "MARY",
"credential": "MA, MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-04-24",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "103961",
"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 Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.