Individual provider Active NPI

Judith Anne Beadles, MFT

  • Marriage & Family Therapist
  • Costa Mesa, CA
National Provider Identifier
1255482725
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
X34161 Issued in CA
Practice address
950 S Coast Dr
Suite 110
Costa Mesa, CA 92626-1776
Phone
(714) 751-6678
Fax
(949) 859-6655
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 X34161 CA Primary

Addresses

Primary practice location

950 S Coast Dr
Suite 110
Costa Mesa, CA 92626-1776

Mailing address

950 S Coast Dr
Suite 110
Costa Mesa, CA 92626-1776
Phone (714) 751-6678

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

LicenseStateTypeSpecialty
X34161CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255482725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 S COAST DR",
            "address_2": "SUITE 110",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261776",
            "telephone_number": "714-751-6678",
            "fax_number": "949-859-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 S COAST DR",
            "address_2": "SUITE 110",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261776",
            "telephone_number": "714-751-6678",
            "fax_number": "949-859-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEADLES",
        "first_name": "JUDITH",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "X34161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.