Individual provider Active NPI

Michael Jeffrey Allen, MFTI IMF66468

  • Marriage & Family Therapist
  • Fresno, CA
National Provider Identifier
1255756177
Registry record updated Feb 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMF 66468 Issued in CA
Practice address
584 E Woodhaven LN
Fresno, CA 93720-1284
Phone
(248) 752-2068
NPI assigned
Feb 28, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2014

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 IMF 66468 CA Primary

Addresses

Primary practice location

584 E Woodhaven LN
Fresno, CA 93720-1284

Mailing address

584 E Woodhaven LN
Fresno, CA 93720-1284
Phone (248) 752-2068

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
IMF 66468CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1393545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393545600000",
    "number": "1255756177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "584 E WOODHAVEN LN",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937201284",
            "telephone_number": "248-752-2068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "584 E WOODHAVEN LN",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937201284",
            "telephone_number": "248-752-2068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "MICHAEL",
        "middle_name": "JEFFREY",
        "credential": "MFTI IMF66468",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-28",
        "last_updated": "2014-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF 66468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; 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.