Individual provider Active NPI

Mitchell Jay Cohen, M.F.T.

  • Marriage & Family Therapist
  • Temecula, CA
National Provider Identifier
1003971235
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC22123 Issued in CA
Practice address
41690 Enterprise Cir N
Suite 209
Temecula, CA 92590-5616
Phone
(951) 296-9919
Fax
(951) 296-9919
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MFC22123 CA Primary

Addresses

Primary practice location

41690 Enterprise Cir N
Suite 209
Temecula, CA 92590-5616

Mailing address

41690 Enterprise Cir N
Suite 209
Temecula, CA 92590-5616
Phone (951) 296-9919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 25, 2024 through Mar 25, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC22123CAMDMarriage & Family Therapist
22123CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003971235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41690 ENTERPRISE CIR N",
            "address_2": "SUITE 209",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925905616",
            "telephone_number": "951-296-9919",
            "fax_number": "951-296-9919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41690 ENTERPRISE CIR N",
            "address_2": "SUITE 209",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925905616",
            "telephone_number": "951-296-9919",
            "fax_number": "951-296-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "MITCHELL",
        "middle_name": "JAY",
        "name_prefix": "Mr.",
        "credential": "M.F.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC22123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.