Active NPI
Alyssa Ashley Green, MS, LMFT
- Marriage & Family Therapist
- Placentia, CA
National Provider Identifier
1366906562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 86109
- Practice address
- 101 S Kraemer Blvd Ste 110
Placentia, CA 92870-6109 - Phone
- (171) 499-6241
- NPI assigned
- Jan 22, 2019
- Last updated
- Jan 22, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 86109 | CA | Primary |
Addresses
Primary practice location
101 S Kraemer Blvd Ste 110
Placentia, CA 92870-6109
Mailing address
577 Las Palmas Dr
Irvine, CA 92602-2315
Phone (909) 938-4952
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, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
15635 Alton Pkwy
Suite 350
Irvine, CA 92618-7333
Phone (949) 528-6300
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86109 | CA | MD | Marriage & Family Therapist |
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.
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- Irvine, CA
- NPI 1174945554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548115200000",
"number": "1366906562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "577 LAS PALMAS DR",
"city": "IRVINE",
"state": "CA",
"postal_code": "926022315",
"telephone_number": "909-938-4952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 S KRAEMER BLVD STE 110",
"city": "PLACENTIA",
"state": "CA",
"postal_code": "928706109",
"telephone_number": "171-499-6241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "ALYSSA",
"middle_name": "ASHLEY",
"name_prefix": "Mrs.",
"credential": "MS, LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-22",
"last_updated": "2019-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "86109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Placentia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; 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.