John Stafford, AMFT

Individual provider Active NPI Marriage & Family Therapist · Aguanga, CA

NPI 1184337495 · NPPES record last updated Jan 3, 2023

Key facts

NPI
1184337495
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
124898 (CA)
Practice address
45525 Highway 79 # 53
Aguanga, CA 92536-8601
Phone
(760) 459-4428
NPI assigned
Jan 2, 2023
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
124898CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Moments Life Coaching LLC Current
since Aug 11, 2024
Accepting new patients
John Stafford LLC Marriage & Family Therapist Current
since Jan 8, 2023
Accepting new patients

Locations

45525 Highway 79
#53
Aguanga, CA 92536
Phone (760) 459-4428

45600 Highway 79
Unit 451
Aguanga, CA 92536

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 124898 CA Yes

Addresses

Primary practice location

45525 Highway 79 # 53
Aguanga, CA 92536-8601

Mailing address

45600 Highway 79 Unit 451
Aguanga, CA 92536-6818
Phone (760) 459-4428

Other identifiers

IdentifierTypeStateIssuer
15827578OtherCAQH

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://npiregistry.cms.hhs.gov/api/?version=2.1 Direct

Other providers in Aguanga, CA

All providers in Aguanga, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.