Jacqueline Islas, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

100262 Issued in CA

Practice address

1151 Dove St Ste 140
Newport Beach, CA 92660-2837

Phone

(949) 630-5006

NPI assigned

Jan 9, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 7, 2024 through Feb 7, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1003153149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52682",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926192682",
            "telephone_number": "949-630-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 DOVE ST STE 140",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602837",
            "telephone_number": "949-630-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAS",
        "first_name": "JACQUELINE",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-09",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "100262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taryn Ishida, ARNP
• Yuichi Ishida, M.D.
• Srijeeta F Islam
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• Yazmin Islas Lopez
• Dipti Itchhaporia, MD
• IV Regeneration Room
• Kristen Dana Iverson, PH.D.
• Ramon Lawrence Ivey, LMFT
• Ivy Health Inc.

• Marriage & Family Therapist in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.