Active NPI
Jazmyne Elaine Fortman
- Marriage & Family Therapist
- Orange, CA
National Provider Identifier
1134894686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 155910
- Practice address
- 238 S Flower St
Orange, CA 92868-3415 - Phone
- (714) 472-7428
- NPI assigned
- Aug 16, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 155910 | CA | Primary |
Addresses
Primary practice location
238 S Flower St
Orange, CA 92868-3415
Mailing address
8606 Commonwealth Ave Apt 156
Buena Park, CA 90621-5117
Phone (714) 472-7428
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 |
|---|---|---|---|
| 155910 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for New Directions, Inc. | Mental Health | Past | Accepting new patients |
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.
-
- Mental Health Counselor
- Laguna Hills, CA
- NPI 1578121190
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768176000000",
"number": "1134894686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8606 COMMONWEALTH AVE APT 156",
"city": "BUENA PARK",
"state": "CA",
"postal_code": "906215117",
"telephone_number": "714-472-7428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "238 S FLOWER ST",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683415",
"telephone_number": "714-472-7428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTMAN",
"first_name": "JAZMYNE",
"middle_name": "ELAINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-16",
"last_updated": "2026-01-12",
"certification_date": "2026-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "155910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.