Organization Active NPI

Tide and Shore Marriage and Family Therapy

  • Marriage & Family Therapist
  • Thousand Oaks, CA
National Provider Identifier
1174401236
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
TIDE AND SHORE MARRIAGE AND FAMILY THERAPY
Practice address
516 Pennsfield PL Ste 208
Thousand Oaks, CA 91360-5530
Phone
(805) 694-0251
NPI assigned
Aug 25, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Authorized official

Name
Kaidi LiuNPI 1932712213
Title
Owner
Phone
(818) 606-9079

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

516 Pennsfield PL Ste 208
Thousand Oaks, CA 91360-5530

Mailing address

2075 Hietter Ave
Simi Valley, CA 93063-2851
Phone (805) 694-0251

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1756080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756080000000",
    "number": "1174401236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2075 HIETTER AVE",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930632851",
            "telephone_number": "805-694-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 PENNSFIELD PL STE 208",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605530",
            "telephone_number": "805-694-0251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDE AND SHORE MARRIAGE AND FAMILY THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-25",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "KAIDI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-606-9079"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; 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.