Individual provider Active NPI

Lissett Chavez Murillo

  • Professional Counselor
  • Fountain Valley, CA
National Provider Identifier
1124552955
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
16590 Issued in CA
Practice address
18350 Mount Langley St Ste 200
Fountain Valley, CA 92708-6912
Phone
(714) 378-2620
NPI assigned
Apr 19, 2017
Last updated
May 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 16590 CA Primary

Addresses

Primary practice location

18350 Mount Langley St Ste 200
Fountain Valley, CA 92708-6912

Mailing address

200 W Santa Ana Blvd
Santa Ana, CA 92701-4134
Phone (714) 704-5900

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
I20250724002097 CA Practitioner - Mental Health Counselor 1254848377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spring to Autumn Family Counseling, Inc.Group PAC ID 1254773054, 18 clinicians

Practice addresses (Care Compare)

2068 Orange Tree LN
Suite 216
Redlands, CA 92374-4555
Phone (909) 557-6574

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16590CAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Western Youth Services CurrentSince Apr 11, 2021 Accepting new patients
Spring to Autumn Family Counseling, Inc. CurrentSince Jul 10, 2025 Accepting new patients

Locations

18350 Mount Langley St
Ste 200
Fountain Valley, CA 92708
Phone (714) 450-4118

1275 W Park Ave
#7461
Redlands, CA 92373

2068 Orange Tree Ln
Ste 216
Redlands, CA 92374
Phone (909) 553-0448

11870 Pierce St
Ste 150
Riverside, CA 92505
Phone (909) 557-6574

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, 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": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1124552955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W SANTA ANA BLVD",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014134",
            "telephone_number": "714-704-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18350 MOUNT LANGLEY ST STE 200",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086912",
            "telephone_number": "714-378-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ MURILLO",
        "first_name": "LISSETT",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-19",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "16590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.