Individual provider Active NPI

Lien Kim-Nguyen Blyth, M.A.

  • Marriage & Family Therapist
  • Costa Mesa, CA
National Provider Identifier
1053864298
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
101708 Issued in CA
Practice address
2973 Harbor Blvd Ste 715
Costa Mesa, CA 92626-3912
Phone
(714) 584-9969
NPI assigned
Jul 24, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X
Marriage & Family Therapist 106H00000X 101708 CA Primary

Addresses

Primary practice location

2973 Harbor Blvd Ste 715
Costa Mesa, CA 92626-3912

Mailing address

2973 Harbor Blvd Ste 715
Costa Mesa, CA 92626-3912
Phone (714) 584-9969

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
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Western Youth Services Past Accepting new patients
New Alternatives Inc. 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": "1469318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1053864298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2973 HARBOR BLVD STE 715",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263912",
            "telephone_number": "714-584-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2973 HARBOR BLVD STE 715",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263912",
            "telephone_number": "714-584-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLYTH",
        "first_name": "LIEN",
        "middle_name": "KIM-NGUYEN",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-24",
        "last_updated": "2021-04-05",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "101708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; 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.