Individual provider Active NPI

Jennifer McNally Pourvasei, MFT

  • Marriage & Family Therapist
  • Santa Ana, CA
National Provider Identifier
1215107024
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
49598 Issued in CA
Practice address
1221 E Dyer Rd Ste 220
Santa Ana, CA 92705-5632
Phone
(714) 323-0631
NPI assigned
Mar 7, 2008
Last updated
Jul 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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 49598 CA Primary

Addresses

Primary practice location

1221 E Dyer Rd Ste 220
Santa Ana, CA 92705-5632

Mailing address

1601 Dove St
Ste 230
Newport Beach, CA 92660-2433
Phone (949) 292-5576

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
49598CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1215107024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 DOVE ST",
            "address_2": "STE 230",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602433",
            "telephone_number": "949-292-5576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 E DYER RD STE 220",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927055632",
            "telephone_number": "714-323-0631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POURVASEI",
        "first_name": "JENNIFER",
        "middle_name": "MCNALLY",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-07",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "49598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; 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.