NPIMap

Organization Active NPI

Timothy Collister PHD, Inc.

  • Marriage & Family Therapist
  • Huntington Park, CA
National Provider Identifier
1932224987
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMF51448 Issued in CA
Legal business name
TIMOTHY COLLISTER PHD, INC.
Practice address
7024 Seville Ave Ste D
Huntington Park, CA 90255-4969
Phone
(323) 588-9600
Fax
(323) 588-9696
NPI assigned
Mar 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Karla Elizabeth Perez, M.A.
Title
MFT Intern
Phone
(626) 914-9609

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMF51448 CA Primary

Addresses

Primary practice location

7024 Seville Ave Ste D
Huntington Park, CA 90255-4969

Mailing address

13525 Tracy St Apt a
Baldwin Park, CA 91706-4766
Phone (626) 813-9548

National Provider Directory

National Provider Directory
Tax ID family
Dr Collister and Associates3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932224987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13525 TRACY ST APT A",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917064766",
            "telephone_number": "626-813-9548",
            "fax_number": "626-813-9548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7024 SEVILLE AVE STE D",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902554969",
            "telephone_number": "323-588-9600",
            "fax_number": "323-588-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY COLLISTER PHD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "KARLA",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "MFT INTERN",
        "authorized_official_telephone_number": "626-914-9609",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF51448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.