Samantha S Agricola

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

133092 Issued in CA

Practice address

1000 Quail St Ste 170
Newport Beach, CA 92660-2765

Phone

(714) 900-3370

NPI assigned

Aug 28, 2024

Last updated

Aug 28, 2024By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1275367583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5815 WRIGHTCREST DR",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902323050",
            "telephone_number": "310-780-7395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 QUAIL ST STE 170",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602765",
            "telephone_number": "714-900-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGRICOLA",
        "first_name": "SAMANTHA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "133092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Newport Beach, CA
• Providers in Newport Beach, 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 Aug 28, 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.