Active NPI
Mark Callahan, LMFT
- Marriage & Family Therapist
- Victorville, CA
National Provider Identifier
1063563245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 106759
- Practice address
- 12421 Hesperia Rd Ste 2
Victorville, CA 92395-7704 - Phone
- (760) 243-5417
- Fax
- (760) 780-4591
- NPI assigned
- Jan 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 106759 | CA | Primary |
| Marriage & Family Therapist | 106H00000X | |||
| Day Training/Habilitation Specialist | 373H00000X |
Addresses
Primary practice location
12421 Hesperia Rd Ste 2
Victorville, CA 92395-7704
Mailing address
12421 Hesperia Rd Ste 2
Victorville, CA 92395-7704
Phone (607) 686-4742
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 |
|---|---|---|---|
| 106759 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744675200000",
"number": "1063563245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12421 HESPERIA RD STE 2",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923957704",
"telephone_number": "607-686-4742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12421 HESPERIA RD STE 2",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923957704",
"telephone_number": "760-243-5417",
"fax_number": "760-780-4591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALLAHAN",
"first_name": "MARK",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-15",
"last_updated": "2025-04-15",
"certification_date": "2025-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "106759",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "373H00000X",
"taxonomy_group": "",
"desc": "Day Training/Habilitation Specialist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.