Individual provider Active NPI

Tanya Suellen Ward

  • Marriage & Family Therapist
  • Huntington Beach, CA
National Provider Identifier
1104130830
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
77110 Issued in CA
Practice address
2124 Main St
Suite 165
Huntington Beach, CA 92648-2405
Phone
(714) 536-0077
NPI assigned
Aug 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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 77110 CA Primary

Addresses

Primary practice location

2124 Main St
Suite 165
Huntington Beach, CA 92648-2405

Mailing address

265 S Randolph Ave Ste 250
Brea, CA 92821-5701
Phone (714) 308-9364

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
I20250210003007 CA Practitioner - Marriage and Family Therapist 7517497266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

265 S Randolph Ave
Brea, CA 92821-5754
Phone (714) 494-9342

265 S Randolph Ave
Suite 160
Brea, CA 92821-5785
Phone (714) 308-9364

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tanya Ward Family Psychotherapy Corporation Marriage & Family Therapist CurrentSince Dec 18, 2024 Accepting new patients
Hope Springs Collective CurrentSince May 12, 2026 Accepting new patients
South Coast Children'S Society, Inc PastSince Sep 1, 2020 Accepting new patients
South Coast Children'S Society, Inc Past Accepting new patients

Locations

265 S Randolph Ave
Ste 160
Brea, CA 92821
Phone (714) 584-0090

265 S Randolph Ave
Ste 250
Brea, CA 92821
Phone (657) 243-2248

265 S Randolph Ave
Brea, CA 92821
Phone (657) 246-3075

Organizations & group practices 4

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": "1280966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1104130830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 S RANDOLPH AVE STE 250",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928215701",
            "telephone_number": "714-308-9364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 MAIN ST",
            "address_2": "SUITE 165",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926482405",
            "telephone_number": "714-536-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "TANYA",
        "middle_name": "SUELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-05",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "77110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.