Individual provider Active NPI

Miaisha Illeene James, LMFT

  • Marriage & Family Therapist
  • Upland, CA
National Provider Identifier
1982744116
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT139852 Issued in CA
Practice address
954 W. Foothill Blvd
Suite a
Upland, CA 91786-3782
Phone
(909) 946-4222
Fax
(909) 946-8243
NPI assigned
Feb 7, 2007
Last updated
Jun 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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 LMFT139852 CA Primary
Rehabilitation Practitioner 225400000X CA

Addresses

Primary practice location

954 W. Foothill Blvd
Suite a
Upland, CA 91786-3782

Mailing address

954 W. Foothill Blvd
Suite a
Upland, CA 91786-3782
Phone (909) 946-4222

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
I20240628002321 CA Practitioner - Marriage and Family Therapist 4880138007 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Foothills Psychological Services IncGroup PAC ID 9436157534, 37 clinicians

Practice addresses (Care Compare)

954 W Foothill Blvd
Suite a
Upland, CA 91786-3782
Phone (909) 946-4222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT139852CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Psychological Services, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Pacific Clinics PastSince Dec 12, 2021 Accepting new patients

Locations

1550 N Park Ave
Pomona, CA 91768
Phone (909) 623-0791

954 W Foothill Blvd
Ste A
Upland, CA 91786
Phone (909) 946-4222

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1982744116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "954 W. FOOTHILL BLVD",
            "address_2": "SUITE A",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863782",
            "telephone_number": "909-946-4222",
            "fax_number": "909-946-8243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 W. FOOTHILL BLVD",
            "address_2": "SUITE A",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863782",
            "telephone_number": "909-946-4222",
            "fax_number": "909-946-8243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "MIAISHA",
        "middle_name": "ILLEENE",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT139852",
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.