Individual provider Active NPI

Valeri Rachelle Trezise, LMFT

  • Marriage & Family Therapist
  • Newport Beach, CA
National Provider Identifier
1174036263
Registry record updated Dec 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
102684 Issued in CA
Practice address
4630 Campus Dr Ste 104
Newport Beach, CA 92660
Phone
(714) 402-8563
NPI assigned
Nov 10, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 102684 CA Primary

Addresses

Primary practice location

4630 Campus Dr Ste 104
Newport Beach, CA 92660

Mailing address

4630 Campus Dr Ste 104
Newport Beach, CA 92660-1804

Other practice location 1

27001 La Paz Rd Ste 403
Mission Viejo, CA 92691-5529
Phone (714) 402-8563

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

LicenseStateTypeSpecialty
102684CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Opener Psychological Services, Inc Multi-Specialty PastSince Oct 18, 2010 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.

NPI Registry JSON

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

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545696000000",
    "number": "1174036263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4630 CAMPUS DR STE 104",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4630 CAMPUS DR STE 104",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92660",
            "telephone_number": "714-402-8563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27001 La Paz Rd Ste 403",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926915529",
            "country_code": "US",
            "telephone_number": "714-402-8563",
            "fax_number": "949-215-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TREZISE",
        "first_name": "VALERI",
        "middle_name": "RACHELLE",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-10",
        "last_updated": "2018-12-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "102684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.