Individual provider Active NPI

Melody Kianna Gorczyca, LMFT

  • Marriage & Family Therapist
  • Temecula, CA
National Provider Identifier
1306446042
Registry record updated Nov 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT135183 Issued in CA
Practice address
27368 Via Industria Ste 101
Temecula, CA 92590-4852
Phone
(951) 414-9873
NPI assigned
Oct 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 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 LMFT135183 CA Primary

Addresses

Primary practice location

27368 Via Industria Ste 101
Temecula, CA 92590-4852

Mailing address

1507 E Valley Pkwy
Ste 3 #495
Escondido, CA 92027
Phone (657) 341-8224

Other practice location 1

41593 Winchester Rd
Temecula, CA 92590-4860
Phone (951) 783-9096

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
I20240219003060 CA Practitioner - Marriage and Family Therapist 1850735721 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT135183CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wise Mind Counseling Services Inc. Marriage & Family Therapist CurrentSince Jan 22, 2024 Accepting new patients

Locations

11801 Pierce St
Ste 200
Riverside, CA 92505
Phone (323) 547-2662

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668211200000",
    "number": "1306446042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 E VALLEY PKWY",
            "address_2": "STE 3 #495",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "92027",
            "telephone_number": "657-341-8224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27368 VIA INDUSTRIA STE 101",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925904852",
            "telephone_number": "951-414-9873"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41593 Winchester Rd",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925904860",
            "country_code": "US",
            "telephone_number": "951-783-9096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORCZYCA",
        "first_name": "MELODY",
        "middle_name": "KIANNA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-30",
        "last_updated": "2022-11-12",
        "certification_date": "2022-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT135183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.