Individual provider Active NPI

Patricia J Lundquist

  • Marriage & Family Therapist
  • Newport Beach, CA
National Provider Identifier
1275279317
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
126634 Issued in CA
Practice address
23 Corporate Plaza Dr Ste 150
Newport Beach, CA 92660-7908
Phone
(949) 393-8662
NPI assigned
May 11, 2022
Last updated
May 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2022

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 126634 CA Primary

Addresses

Primary practice location

23 Corporate Plaza Dr Ste 150
Newport Beach, CA 92660-7908

Mailing address

27472 Portola Pkwy Ste 200
Foothill Ranch, CA 92610-2853
Phone (949) 239-7582

Other identifiers 1

IdentifierTypeStateIssuer
29133OtherCASTATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://ocrc.janeapp.com/ Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250808002018 CA Practitioner - Marriage and Family Therapist 3678071636 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
126634CAMDMental Health Counselor
29133CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Pain Management Medical Group, Inc. CurrentSince Jun 25, 2025 Accepting new patients

Locations

999 N Tustin Ave
Ste 201
Santa Ana, CA 92705
Phone (714) 975-7950

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1275279317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27472 PORTOLA PKWY STE 200",
            "city": "FOOTHILL RANCH",
            "state": "CA",
            "postal_code": "926102853",
            "telephone_number": "949-239-7582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 CORPORATE PLAZA DR STE 150",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607908",
            "telephone_number": "949-393-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDQUIST",
        "first_name": "PATRICIA",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-11",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "126634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "29133",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://ocrc.janeapp.com/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EDI",
            "address_1": "23 Corporate Plaza Dr Ste 150",
            "city": "Newport Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926607908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.