Individual provider Active NPI

Erin Fennell, LMFT

  • Marriage & Family Therapist
  • Laguna Niguel, CA
National Provider Identifier
1083091094
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
102874 Issued in CA
Practice address
28202 Cabot Rd Ste 300
Laguna Niguel, CA 92677-1249
Phone
(949) 478-5288
NPI assigned
Apr 28, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 102874 CA Primary
Marriage & Family Therapist 106H00000X BBH-LMFT-LIC-87690 MT
Marriage & Family Therapist 106H00000X MBTMFT-10270 ID

Addresses

Primary practice location

28202 Cabot Rd Ste 300
Laguna Niguel, CA 92677-1249

Mailing address

30025 Alicia Pkwy # 20-2200
Laguna Niguel, CA 92677-2090
Phone (949) 478-5288

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
I20250205001521 CA Practitioner - Marriage and Family Therapist 9931639085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Practice addresses (Care Compare)

4633 Old Ironsides Dr
Suite 304
Santa Clara, CA 95054-1846
Phone (866) 280-0260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MBTMFT-10270IDMDMarriage & Family Therapist
BBH-LMFT-LIC-87690MTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sud Specialty Group - Ca Marriage & Family Therapist CurrentSince Jan 30, 2025 Accepting new patients

Locations

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1430179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1083091094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30025 ALICIA PKWY # 20-2200",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772090",
            "telephone_number": "949-478-5288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28202 CABOT RD STE 300",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926771249",
            "telephone_number": "949-478-5288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNELL",
        "first_name": "ERIN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-28",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "102874",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MT",
            "license": "BBH-LMFT-LIC-87690",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ID",
            "license": "MBTMFT-10270",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Niguel, CA

Sources for this page

Verify at the official NPI Registry.