Individual provider Active NPI

Deborah J Bernal, M.F.T.

  • Marriage & Family Therapist
  • Los Alamitos, CA
National Provider Identifier
1225212400
Registry record updated Dec 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 42284 Issued in CA
Practice address
4132 Katella Avenue
Suite 104
Los Alamitos, CA 90720-3493
Phone
(714) 814-0207
Fax
(562) 598-5997
NPI assigned
Dec 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 24, 2007

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 MFC 42284 CA Primary

Addresses

Primary practice location

4132 Katella Avenue
Suite 104
Los Alamitos, CA 90720-3493

Mailing address

4132 Katella Avenue
Suite 104
Los Alamitos, CA 90720-3493
Phone (562) 598-5991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 14, 2025 through Jan 14, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC 42284CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Counseling Group Marriage & Family Therapist PastSince Feb 9, 2024 Accepting new patients
Grace Counseling Group Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198454400000",
    "number": "1225212400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4132 KATELLA AVENUE",
            "address_2": "SUITE 104",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203493",
            "telephone_number": "562-598-5991",
            "fax_number": "562-598-5997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4132 KATELLA AVENUE",
            "address_2": "SUITE 104",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203493",
            "telephone_number": "714-814-0207",
            "fax_number": "562-598-5997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNAL",
        "first_name": "DEBORAH",
        "middle_name": "J",
        "credential": "M.F.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-24",
        "last_updated": "2007-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 42284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

Verify at the official NPI Registry.