Individual provider Active NPI

Maria Leonor Haydis, LMFT

  • Marriage & Family Therapist
  • Irvine, CA
National Provider Identifier
1174105969
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
140483 Issued in CA
Practice address
2030 Main St Ste 1300
Irvine, CA 92614-7220
Phone
(714) 450-6412
NPI assigned
Apr 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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 140483 CA Primary

Addresses

Primary practice location

2030 Main St Ste 1300
Irvine, CA 92614-7220

Mailing address

2030 Main St Ste 1300
Irvine, CA 92614-7220
Phone (714) 450-6412

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
I20240415003614 CA Practitioner - Marriage and Family Therapist 9436598091 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Marriage & Family Therapist CurrentSince Sep 11, 2024 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Feb 3, 2025 Accepting new patients
Providence Medical Foundation CurrentSince Feb 3, 2025 Accepting new patients
Western Youth Services PastSince Jun 11, 2023 Accepting new patients
Kamala Thomas Psychological Services Corp PastSince Dec 5, 2020 Accepting new patients

Locations

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

2212 E 4th St
Santa Ana, CA 92705
Phone (714) 288-3230

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 6

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": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1174105969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 MAIN ST STE 1300",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926147220",
            "telephone_number": "714-450-6412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 MAIN ST STE 1300",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926147220",
            "telephone_number": "714-450-6412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYDIS",
        "first_name": "MARIA",
        "middle_name": "LEONOR",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "140483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.