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IVONNE THELMA CAMPUZANO
NPI 1043786502
Marriage & Family Therapist in Los Angeles, CA

Active since October 22, 2018PECOS Enrolled
611 WILSHIRE BLVD, 9TH FLOOR, UNIT #574, LOS ANGELES, CA 90017(213) 955-7250 Get Directions Write a Review

NPPES record last updated: January 11, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 14, 2021, Oct 1, 2019, Feb 1, 2019 and 1 more (4 updates tracked since 2018).

About Ivonne Thelma Campuzano NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IVONNE THELMA CAMPUZANO (NPI 1043786502) is an individual marriage & family therapist in Los Angeles, California, licensed in California (LMFT123631) and active in the NPI registry since October 2018. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1043786502
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameIVONNE THELMA CAMPUZANO
Location Address611 WILSHIRE BLVD, 9TH FLOOR, UNIT #574Los Angeles, CA 90017
Mailing Address611 Wilshire Blvd 9th Fl, Unit #574Los Angeles, CA 90017-4025 · (213) 955-7250
Phone(213) 955-7250
Sole ProprietorYes
Enumeration DateOctober 22, 2018
Last NPPES UpdateJanuary 11, 20244 updates tracked since enumeration
NPPES CertifiedJanuary 11, 2024
✔ NPI 1043786502 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
Licenses✔ Licensed in CA · LMFT123631✔ Licensed in CA · AMFT109225
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License AMFT109225 (CA)
Also ListedRehabilitation PractitionerTaxonomy 225400000X
611 WILSHIRE BLVD, Los Angeles, CA 90017
Open in Google Maps ↗

Secondary Practice Locations 2

Location 12750 E Washington Blvd Ste 230Pasadena, CA 91107-1449 · Phone (626) 296-8900
Location 266 Hurlbut StPasadena, CA 91105-4025 · Phone (626) 441-4221

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ivonne Thelma Campuzano is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Ivonne Campuzano reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Cyti Health PC
112 mi
Mental Health (Including Community Mental Health Center)
402 W BROADWAY STE 400
San Diego, CA 92101
  • Reassigned Medicare billing, California enrollment
  • 545 clinicians in this Medicare group
NPI 1679172290 (866) 478-3978
Grow Healthcare Group PC
305 mi
Mental Health
99 S ALMADEN BLVD STE 600
San Jose, CA 95113
  • Reassigned Medicare billing, California enrollment
  • 3,139 clinicians in this Medicare group
NPI 1154994846 (408) 402-4385

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WOMEN FOR CHANGE FOUNDATION
Community/Behavioral Health
611 WILSHIRE BLVD, STE 1401
LOS ANGELES, CA 90017
Los Angeles County (877) 266-7419
MR. JOSE LUIS RANGEL-GARIBAY MPH, CHES
Health Educator
611 WILSHIRE BLVD, SUITE 900
LOS ANGELES, CA 90017
Los Angeles County (323) 966-2890
ALISSA SINGER MPH
Health Educator
611 WILSHIRE BLVD, STE 900
LOS ANGELES, CA 90017
Los Angeles County (323) 966-2890

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ivonne Campuzano's NPI number?

The NPI number for Ivonne Campuzano is 1043786502. It was assigned to this individual provider in the NPPES registry on October 22, 2018.

Where is Ivonne Campuzano located?

Ivonne Campuzano practices at 611 Wilshire Blvd 9th Floor, Unit #574, Los Angeles, CA 90017. The listed phone number is (213) 955-7250.

What is Ivonne Campuzano's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Ivonne Campuzano enrolled in Medicare?

Yes. Ivonne Campuzano is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Ivonne Campuzano's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ivonne Campuzano reassigns Medicare benefits to 2 organizations: Cyti Health PC (San Diego, CA) and Grow Healthcare Group PC (San Jose, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ivonne Campuzano's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Ivonne Campuzano was last updated on January 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.