Individual provider Active NPI

Justine Short

  • Marriage & Family Therapist
  • Corona, CA
National Provider Identifier
1316332216
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
2275 S Main St
Suite 201
Corona, CA 92882-5303
Phone
(951) 279-3222
Fax
(951) 279-5222
NPI assigned
Mar 30, 2015
Last updated
Jan 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

2275 S Main St
Suite 201
Corona, CA 92882-5303

Mailing address

2275 S Main St
Suite 201
Corona, CA 92882-5303
Phone (951) 279-3222

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
I20240401002729 CA Practitioner - Marriage and Family Therapist 9638517386 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clear View Behavioral Services Marriage & Family Therapist CurrentSince Mar 19, 2024 Accepting new patients

Locations

1902 Orange Tree Ln
Ste 200
Redlands, CA 92374
Phone (909) 798-6200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1316332216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 S MAIN ST",
            "address_2": "SUITE 201",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928825303",
            "telephone_number": "951-279-3222",
            "fax_number": "951-279-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 S MAIN ST",
            "address_2": "SUITE 201",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928825303",
            "telephone_number": "951-279-3222",
            "fax_number": "951-279-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "JUSTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.