Individual provider Active NPI

Andrea Kimiko Sugino, LMFT

  • Marriage & Family Therapist
  • Newport Beach, CA
National Provider Identifier
1043603715
Registry record updated Sep 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
164559 Issued in CA
Practice address
4930 Campus Dr
Newport Beach, CA 92660-2119
Phone
(714) 257-5291
NPI assigned
Mar 5, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2026

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 164559 CA Primary

Addresses

Primary practice location

4930 Campus Dr
Newport Beach, CA 92660-2119

Mailing address

4930 Campus Dr
Newport Beach, CA 92660-2119
Phone (714) 257-5291

Other practice location 1

12821 Newport Ave
Tustin, CA 92780-2711
Phone (714) 803-4866

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jasper Mountain PastSince Aug 29, 2021 Accepting new patients
Jasper Mountain Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788739200000",
    "number": "1043603715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 CAMPUS DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602119",
            "telephone_number": "714-257-5291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4930 CAMPUS DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602119",
            "telephone_number": "714-257-5291"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12821 Newport Ave",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927802711",
            "country_code": "US",
            "telephone_number": "714-803-4866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUGINO",
        "first_name": "ANDREA",
        "middle_name": "KIMIKO",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-05",
        "last_updated": "2026-09-07",
        "certification_date": "2026-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "164559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2026; 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.