Active NPI
Jordan C. Gray, LMFT
- Marriage & Family Therapist
- Irvine, CA
National Provider Identifier
1003249376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 106723
- Practice address
- 1127 Grand Canal
Irvine, CA 92620-1897 - Phone
- (330) 349-2620
- NPI assigned
- Aug 9, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 106723 | CA | Primary |
Addresses
Primary practice location
1127 Grand Canal
Irvine, CA 92620-1897
Mailing address
340 East First Street
P.O. Box #1790
Tustin, CA 92781
Phone (510) 978-8235
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106723 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676937600000",
"number": "1003249376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 EAST FIRST STREET",
"address_2": "P.O. BOX #1790",
"city": "TUSTIN",
"state": "CA",
"postal_code": "92781",
"telephone_number": "510-978-8235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1127 GRAND CANAL",
"city": "IRVINE",
"state": "CA",
"postal_code": "926201897",
"telephone_number": "330-349-2620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "JORDAN",
"middle_name": "C.",
"name_prefix": "Mr.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-08-09",
"last_updated": "2023-02-21",
"certification_date": "2023-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "106723",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.