Individual provider Active NPI

Agustina M Garcia

  • Marriage & Family Therapist
  • Long Beach, CA
National Provider Identifier
1982005641
Registry record updated Apr 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT105640 Issued in CA
Practice address
5150 E Pacific Coast Hwy
Suite100
Long Beach, CA 90804-3312
Phone
(562) 490-7600
Fax
(562) 490-7601
NPI assigned
Sep 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2018

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 LMFT105640 CA Primary

Addresses

Primary practice location

5150 E Pacific Coast Hwy
Suite100
Long Beach, CA 90804-3312

Mailing address

5150 E Pacific Coast Hwy
Suite100
Long Beach, CA 90804-3312
Phone (562) 490-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240117002859 CA Practitioner - Marriage and Family Therapist 0941652754 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT105640CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Soultenders, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Soultenders Psychological Services, Inc. CurrentSince Jul 1, 2026 Accepting new patients
Childnet Youth and Family Services Inc Past Accepting new patients
Allyson Wells MD Inc PastSince Oct 19, 2020 Accepting new patients

Locations

41 E Foothill Blvd
Ste 102
Arcadia, CA 91006
Phone (626) 701-4249

17326 Edwards Rd
Ste A135
Cerritos, CA 90703
Phone (562) 222-5258

19112 Gridley Rd
Ste 104
Cerritos, CA 90703
Phone (562) 222-5258

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522800000000",
    "number": "1982005641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 E PACIFIC COAST HWY",
            "address_2": "SUITE100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908043312",
            "telephone_number": "562-490-7600",
            "fax_number": "562-490-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 E PACIFIC COAST HWY",
            "address_2": "SUITE100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908043312",
            "telephone_number": "562-490-7600",
            "fax_number": "562-490-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "AGUSTINA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2018-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT105640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.