Active NPI
Prerna M Rao, MFT-INTERN
- Marriage & Family Therapist
- Newport Beach, CA
National Provider Identifier
1235495425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 64564
- Practice address
- 1601 Dove St
Suite 230
Newport Beach, CA 92660 - Phone
- (949) 799-4040
- NPI assigned
- Apr 2, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 64564 | CA | Primary |
Addresses
Primary practice location
1601 Dove St
Suite 230
Newport Beach, CA 92660
Mailing address
307 Placentia Ave
Suite 109B
Newport Beach, CA 92663
Phone (949) 799-4040
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
| License | State | Type | Specialty |
|---|---|---|---|
| 64564 | CA | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578960000000",
"number": "1235495425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 PLACENTIA AVE",
"address_2": "SUITE 109B",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "92663",
"telephone_number": "949-799-4040",
"fax_number": "949-764-6767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 DOVE ST",
"address_2": "SUITE 230",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "92660",
"telephone_number": "949-799-4040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAO",
"first_name": "PRERNA",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "MFT-INTERN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-02",
"last_updated": "2020-01-14",
"certification_date": "2020-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "64564",
"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 Jan 14, 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.