Active NPI
Chelsea Rose Corgan
- Marriage & Family Therapist
- Anaheim, CA
National Provider Identifier
1275841983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 112179
- Practice address
- 2531 W Woodland Dr
Anaheim, CA 92801-2637 - Phone
- (714) 338-1017
- Fax
- (714) 426-8161
- NPI assigned
- Sep 15, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 112179 | CA | Primary |
Addresses
Primary practice location
2531 W Woodland Dr
Anaheim, CA 92801-2637
Mailing address
1501 Hughes Way Ste 150
Long Beach, CA 90810-1878
Phone (310) 221-6336
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
| License | State | Type | Specialty |
|---|---|---|---|
| 112179 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592438400000",
"number": "1275841983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 HUGHES WAY STE 150",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908101878",
"telephone_number": "310-221-6336",
"fax_number": "310-221-6350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2531 W WOODLAND DR",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928012637",
"telephone_number": "714-338-1017",
"fax_number": "714-426-8161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORGAN",
"first_name": "CHELSEA",
"middle_name": "ROSE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-15",
"last_updated": "2020-06-18",
"certification_date": "2020-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "112179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.