Individual provider Active NPI

Wendy S Concepcion, LMFT

  • Marriage & Family Therapist
  • Tustin, CA
National Provider Identifier
1225535750
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC34651 Issued in CA
Practice address
17772 Irvine Blvd Ste 101
Tustin, CA 92780-3233
Phone
(714) 589-2115
NPI assigned
Apr 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 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 MFC34651 CA Primary

Addresses

Primary practice location

17772 Irvine Blvd Ste 101
Tustin, CA 92780-3233

Mailing address

17772 Irvine Blvd Ste 101
Tustin, CA 92780-3233
Phone (714) 589-2115

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 8, 2024 through Jan 8, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC34651CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1225535750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17772 IRVINE BLVD STE 101",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803233",
            "telephone_number": "714-589-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17772 IRVINE BLVD STE 101",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803233",
            "telephone_number": "714-589-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONCEPCION",
        "first_name": "WENDY",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC34651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.