Organization Active NPI

West Coast Individual and Family Therapy Inc.

  • Marriage & Family Therapist
  • Fountain Valley, CA
National Provider Identifier
1245064245
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
WEST COAST INDIVIDUAL AND FAMILY THERAPY INC.
Practice address
10061 Talbert Ave
Suite 200/365
Fountain Valley, CA 92708
Phone
(714) 222-3864
Fax
(714) 963-4703
NPI assigned
Aug 30, 2024
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Mark Raymond Gery, LMFT
Title
Owner
Phone
(714) 222-3864

National Provider Directory

National Provider Directory

Locations

10061 Talbert Ave
Ste 200365
Fountain Valley, CA 92708
Phone (714) 222-3864

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

10061 Talbert Ave
Suite 200/365
Fountain Valley, CA 92708

Mailing address

2709 South Diamond Street
Santa Ana, CA 92704
Phone (714) 222-3864

Other names 1

NPPES NPI Registry
  • West Coast Therapy Group. Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 30, 2024.

{
    "created_epoch": "1724976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724976000000",
    "number": "1245064245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 SOUTH DIAMOND STREET",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92704",
            "telephone_number": "714-222-3864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10061 TALBERT AVE",
            "address_2": "SUITE 200/365",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "92708",
            "telephone_number": "714-222-3864",
            "fax_number": "714-963-4703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COAST INDIVIDUAL AND FAMILY THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-30",
        "last_updated": "2024-08-30",
        "status": "A",
        "authorized_official_last_name": "GERY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-222-3864",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Coast Therapy Group.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.