Individual provider Active NPI

Taria Joy Mac Millan, LMFT

  • Marriage & Family Therapist
  • Capitola, CA
National Provider Identifier
1033601760
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
25658 Issued in CA
Practice address
603 Capitola Ave
Capitola, CA 95010-2751
Phone
(831) 588-1826
NPI assigned
May 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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 25658 CA Primary

Addresses

Primary practice location

603 Capitola Ave
Capitola, CA 95010-2751

Mailing address

603 Capitola Ave
Capitola, CA 95010-2751
Phone (831) 588-1826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 18, 2025 through Oct 18, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25658CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1033601760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 CAPITOLA AVE",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102751",
            "telephone_number": "831-588-1826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 CAPITOLA AVE",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102751",
            "telephone_number": "831-588-1826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAC MILLAN",
        "first_name": "TARIA JOY",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-30",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "25658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Capitola, CA

Sources for this page

Verify at the official NPI Registry.