Individual provider Active NPI

Pushtana Omar, LMFT, MS

  • Marriage & Family Therapist
  • Orange, CA
National Provider Identifier
1073291993
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
147498 Issued in CA
Practice address
1442 E Lincoln Ave # 225
Orange, CA 92865-1934
Phone
(619) 796-3655
NPI assigned
Jul 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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 147498 CA Primary

Addresses

Primary practice location

1442 E Lincoln Ave # 225
Orange, CA 92865-1934

Mailing address

1442 E Lincoln Ave # 225
Orange, CA 92865-1934
Phone (619) 796-3655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240913001834 CA Practitioner - Marriage and Family Therapist 5799225918 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Cyti Health PC CurrentSince Jul 1, 2024 Accepting new patients

Locations

11801 Pierce St
Riverside, CA 92505
Phone (909) 528-0317

402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939

Organizations & group practices 1

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": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1073291993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1442 E LINCOLN AVE # 225",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928651934",
            "telephone_number": "619-796-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1442 E LINCOLN AVE # 225",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928651934",
            "telephone_number": "619-796-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMAR",
        "first_name": "PUSHTANA",
        "credential": "LMFT, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "147498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.