Traci F Medeiros, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

86600 Issued in CA

Practice address

1440 N Harbor Blvd Ste 600a
Fullerton, CA 92835-4119

Phone

(657) 333-2396

NPI assigned

Jan 26, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 2, 2024 through Feb 2, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Gather and Grow Marriage and Family Therapy, Inc.

  • Mental Health Counselor
  • Fullerton, CA
  • NPI 1255981544

  Marriage & Family Therapist

  NPD

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

{
    "created_epoch": "1485388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1235676339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 N HARBOR BLVD STE 600A",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354119",
            "telephone_number": "657-333-2396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 N HARBOR BLVD STE 600A",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354119",
            "telephone_number": "657-333-2396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDEIROS",
        "first_name": "TRACI",
        "middle_name": "F",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-26",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "86600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louis J McNabb, M.D.
• Esther McOry
• Yvonne Marie Meade, CLINICAL MSW
• April Medal
• Medauxillium
• Alec Michael Meden
• Medical and Healing Arts, Inc
• Medical Center for Women
• Medichex, Inc
• Alina Medina

• Marriage & Family Therapist in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.