Individual provider Active NPI

Patricia Phillips

  • Marriage & Family Therapist
  • Garden Grove, CA
National Provider Identifier
1285750703
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 36393 Issued in CA
Practice address
12377 Lewis Street
Suite 206
Garden Grove, CA 92840-4675
Phone
(562) 338-8434
Fax
(714) 740-0504
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

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 MFC 36393 CA Primary

Addresses

Primary practice location

12377 Lewis Street
Suite 206
Garden Grove, CA 92840-4675

Mailing address

12377 Lewis Street
Suite 206
Garden Grove, CA 92840-4675
Phone (562) 338-8434

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
MFC 36393CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1285750703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12377 LEWIS STREET",
            "address_2": "SUITE 206",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404675",
            "telephone_number": "562-338-8434",
            "fax_number": "714-740-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12377 LEWIS STREET",
            "address_2": "SUITE 206",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404675",
            "telephone_number": "562-338-8434",
            "fax_number": "714-740-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "PATRICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 36393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; 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.