Individual provider Active NPI

Mariam Harris, LMFT

  • Marriage & Family Therapist
  • Rancho Santa Margarita, CA
National Provider Identifier
1023439031
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
78002 Issued in CA
Practice address
22362 Gilberto Ste 130
Rancho Santa Margari, Ca 92688
Rancho Santa Margarita, CA 92688-2142
Phone
(949) 690-5393
NPI assigned
Dec 17, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

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 78002 CA Primary

Addresses

Primary practice location

22362 Gilberto Ste 130
Rancho Santa Margari, Ca 92688
Rancho Santa Margarita, CA 92688-2142

Mailing address

25 Mauchly Ste 319
Irvine, CA 92618-2361
Phone (949) 690-5393

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
I20240102001961 CA Practitioner - Marriage and Family Therapist 6608226758 Reassigns benefits to 1 organization

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
Medens HealthGroup PAC ID 4880014877, 13 clinicians

Practice addresses (Care Compare)

9713 Santa Monica Blvd
Suite 201
Beverly Hills, CA 90210-4236
Phone (833) 624-5400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
78002CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Medens Health Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients

Locations

9713 Santa Monica Blvd
Ste 201
Beverly Hills, CA 90210
Phone (310) 564-5400

2108 N St
Sacramento, CA 95816
Phone (951) 719-7050

402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939

1633 E 4th St
Ste 156
Santa Ana, CA 92701
Phone (562) 452-3893

Organizations & group practices 1

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": "1387238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387238400000",
    "number": "1023439031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MAUCHLY STE 319",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182361",
            "telephone_number": "949-690-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22362 GILBERTO STE 130",
            "address_2": "RANCHO SANTA MARGARI, CA 92688",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882142",
            "telephone_number": "949-690-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MARIAM",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-17",
        "last_updated": "2013-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "78002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Santa Margarita, CA

Sources for this page

Verify at the official NPI Registry.