Active NPI
Tina Keith
- Mental Health Counselor
- Tustin, CA
National Provider Identifier
1033596044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 75424
- Practice address
- 18302 Irvine Blvd
Ste 300
Tustin, CA 92780-3435 - Phone
- (714) 957-1004
- NPI assigned
- Apr 28, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Mental Health Counselor | 101YM0800X | 75424 | CA | Primary |
| Marriage & Family Therapist | 106H00000X | 75424 | CA |
Addresses
Primary practice location
18302 Irvine Blvd
Ste 300
Tustin, CA 92780-3435
Mailing address
18302 Irvine Blvd
Ste 300
Tustin, CA 92780-3435
Phone (714) 957-1004
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 |
|---|---|---|---|
| 75424 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430179200000",
"number": "1033596044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18302 IRVINE BLVD",
"address_2": "STE 300",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927803435",
"telephone_number": "714-957-1004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18302 IRVINE BLVD",
"address_2": "STE 300",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927803435",
"telephone_number": "714-957-1004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEITH",
"first_name": "TINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-28",
"last_updated": "2015-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "75424",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "75424",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.