Active NPI
Mallory Joye Thysell, AMFT
- Marriage & Family Therapist
- Temecula, CA
National Provider Identifier
1336919786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 27349 Jefferson Ave Ste 111
Temecula, CA 92590-5610 - Phone
- (949) 201-8260
- NPI assigned
- Jan 8, 2024
- 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 | Primary |
Addresses
Primary practice location
27349 Jefferson Ave Ste 111
Temecula, CA 92590-5610
Mailing address
30595 Spring Lake Way
Menifee, CA 92584-8021
Phone (951) 239-2462
Other practice location 1
30595 Spring Lake Way
Menifee, CA 92584-8021
Phone (951) 239-2462
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
27349 Jefferson Ave
Suite 111
Temecula, CA 92590-5610
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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.
-
- Mental Health Counselor
- Temecula, CA
- NPI 1811455306
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704672000000",
"number": "1336919786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30595 SPRING LAKE WAY",
"city": "MENIFEE",
"state": "CA",
"postal_code": "925848021",
"telephone_number": "951-239-2462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27349 JEFFERSON AVE STE 111",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925905610",
"telephone_number": "949-201-8260"
}
],
"practiceLocations": [
{
"address_1": "30595 Spring Lake Way",
"address_purpose": "LOCATION",
"city": "Menifee",
"state": "CA",
"postal_code": "925848021",
"country_code": "US",
"telephone_number": "951-239-2462",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THYSELL",
"first_name": "MALLORY",
"middle_name": "JOYE",
"credential": "AMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-08",
"last_updated": "2024-01-08",
"certification_date": "2024-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temecula, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.