Individual provider Active NPI

Janet Frances Park

  • Marriage & Family Therapist
  • Santa Fe Springs, CA
National Provider Identifier
1356623094
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
104757 Issued in CA
Practice address
11731 Telegraph Rd Ste G
Santa Fe Springs, CA 90670-6819
Phone
(562) 942-8256
NPI assigned
Sep 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 104757 CA Primary

Addresses

Primary practice location

11731 Telegraph Rd Ste G
Santa Fe Springs, CA 90670-6819

Mailing address

11731 Telegraph Rd Ste G
Santa Fe Springs, CA 90670-6819
Phone (562) 942-8256

Other practice location 1

3288 El Cajon Blvd Ste 13
San Diego, CA 92104-1430
Phone (619) 521-5720

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
104757CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1316390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1356623094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11731 TELEGRAPH RD STE G",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906706819",
            "telephone_number": "562-942-8256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11731 TELEGRAPH RD STE G",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906706819",
            "telephone_number": "562-942-8256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3288 El Cajon Blvd Ste 13",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921041430",
            "country_code": "US",
            "telephone_number": "619-521-5720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "JANET",
        "middle_name": "FRANCES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-19",
        "last_updated": "2018-03-17",
        "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": "CA",
            "license": "104757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.