Active NPI
Nicole Marie Knowlton, AMFT
- Marriage & Family Therapist
- Newport Beach, CA
National Provider Identifier
1295023075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 122657
- Practice address
- 4120 Birch St Ste 121
Newport Beach, CA 92660-2228 - Phone
- (714) 540-9070
- NPI assigned
- Jul 14, 2011
- 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 | 122657 | CA | Primary |
Addresses
Primary practice location
4120 Birch St Ste 121
Newport Beach, CA 92660-2228
Mailing address
24 Shooting Star
Irvine, CA 92604-3361
Phone (949) 293-7405
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 |
|---|---|---|---|
| 122657 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649030400000",
"number": "1295023075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 SHOOTING STAR",
"city": "IRVINE",
"state": "CA",
"postal_code": "926043361",
"telephone_number": "949-293-7405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4120 BIRCH ST STE 121",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926602228",
"telephone_number": "714-540-9070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNOWLTON",
"first_name": "NICOLE",
"middle_name": "MARIE",
"credential": "AMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-14",
"last_updated": "2022-04-04",
"certification_date": "2022-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "122657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.