Individual provider Active NPI

Breanna Ferentz

  • Mental Health Counselor
  • Newport Beach, CA
National Provider Identifier
1194370379
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
AMFT142665 Issued in CA
Practice address
1600 Dove St Ste 335
Newport Beach, CA 92660-1433
Phone
(949) 395-8246
NPI assigned
Aug 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R1476260722 CA
Mental Health Counselor 101YM0800X AMFT142665 CA Primary

Addresses

Primary practice location

1600 Dove St Ste 335
Newport Beach, CA 92660-1433

Mailing address

1055 E Colorado Blvd Ste 560
Pasadena, CA 91106-2380
Phone (818) 241-6780

Other practice location 1

25201 Paseo De Alicia
Laguna Hills, CA 92653-4626
Phone (949) 793-7375 ext. 110

Other practice location 2

1207 E Fruit St
Santa Ana, CA 92701-4296
Phone (714) 953-9373

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
R1476260722CAMDAddiction (Substance Use Disorder) Counselor
AMFT142665CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Learning Connection, LLC PastSince Aug 1, 2019 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": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1194370379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 E COLORADO BLVD STE 560",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911062380",
            "telephone_number": "818-241-6780",
            "fax_number": "818-241-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 DOVE ST STE 335",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601433",
            "telephone_number": "949-395-8246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25201 Paseo De Alicia",
            "address_purpose": "LOCATION",
            "city": "Laguna Hills",
            "state": "CA",
            "postal_code": "926534626",
            "country_code": "US",
            "telephone_number": "949-793-7375 x110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1207 E Fruit St",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927014296",
            "country_code": "US",
            "telephone_number": "714-953-9373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERENTZ",
        "first_name": "BREANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-05",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1476260722",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "AMFT142665",
            "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 Feb 9, 2024; 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.