Full Circle Wellness Collective, Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

FULL CIRCLE WELLNESS COLLECTIVE, INC.

Practice address

3151 Airway Ave Ste F120
Costa Mesa, CA 92626-4623

Phone

(714) 406-0454

Fax

(714) 617-2934

NPI assigned

Dec 26, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Shahrzad Azarafza, LCSWNPI 1215381538

Title

President/Founder & Psychotherapist

Phone

(714) 406-0454

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shahrzad Azarafza, LCSW

  • Mental Health Counselor
  • Irvine, CA
  • NPI 1215381538
  NPD Authorized official

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

{
    "created_epoch": "1672012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1033822804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 AIRWAY AVE STE F120",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264623",
            "telephone_number": "714-406-0454",
            "fax_number": "714-617-2934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 AIRWAY AVE STE F120",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264623",
            "telephone_number": "714-406-0454",
            "fax_number": "714-617-2934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL CIRCLE WELLNESS COLLECTIVE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-26",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "AZARAFZA",
        "authorized_official_first_name": "SHAHRZAD",
        "authorized_official_title_or_position": "PRESIDENT/FOUNDER & PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "714-406-0454",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215381538",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jesse Oswaldo Fuentes
• Heather Fujii
• Elizabeth Fujimaki, RD
• Danika Nashay Fulbright
• Erin T Fulbright
• Karolina Fuller
• Logan Fuller
• Sharon Ann Fuller, M.A.,M.F.T.
• Lauren Funke
• Ariah Fuqua

• Mental Health Counselor in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.