Individual provider Active NPI

Annmarie Nelson, L.M.F.T.

  • Marriage & Family Therapist
  • Mission Viejo, CA
National Provider Identifier
1215220231
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
97177 Issued in CA
Practice address
27201 Puerta Real Suite 300
PMB 305
Mission Viejo, CA 92691
Phone
(949) 445-0510
NPI assigned
May 24, 2011
Last updated
Mar 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 166001530 IL
Marriage & Family Therapist 106H00000X 002043 NY
Marriage & Family Therapist 106H00000X 204123 TX
Marriage & Family Therapist 106H00000X LMFT97177 CA
Marriage & Family Therapist 106H00000X 97177 CA Primary

Addresses

Primary practice location

27201 Puerta Real Suite 300
PMB 305
Mission Viejo, CA 92691

Mailing address

27201 Puerta Real Suite 300
PMB 305
Mission Viejo, CA 92691
Phone (949) 445-0510

Other practice location 1

26060 Acero
Suite #103
Mission Viejo, CA 92691
Phone (949) 445-0510

Other practice location 2

1130 E Clark Ave # 150-1336
Santa Maria, CA 93455-5178
Phone (714) 536-0077

Other practice location 3

2501 Chatham Rd Ste R
Springfield, IL 62704-4188
Phone (949) 445-0515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 10, 2024 through Jan 10, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
002043NYMDMental Health Counselor
97177CAMDMarriage & Family Therapist
LMFT97177CAMDMarriage & Family Therapist
166001530ILMDMarriage & Family Therapist
204123TXMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1306195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1215220231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27201 PUERTA REAL SUITE 300",
            "address_2": "PMB 305",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92691",
            "telephone_number": "949-445-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27201 PUERTA REAL SUITE 300",
            "address_2": "PMB 305",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92691",
            "telephone_number": "949-445-0510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26060 Acero",
            "address_2": "Suite #103",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "92691",
            "country_code": "US",
            "telephone_number": "949-445-0510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1130 E Clark Ave # 150-1336",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934555178",
            "country_code": "US",
            "telephone_number": "714-536-0077",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2501 Chatham Rd Ste R",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627044188",
            "country_code": "US",
            "telephone_number": "949-445-0515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ANNMARIE",
        "name_prefix": "Ms.",
        "credential": "L.M.F.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-24",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166001530",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "002043",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "204123",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT97177",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "97177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.