Individual provider Active NPI

Jessica Fenton

  • Marriage & Family Therapist
  • Orange, CA
National Provider Identifier
1376000745
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
129110 Issued in CA
Practice address
4000 W Metropolitan Dr Ste 120
Orange, CA 92868-3504
Phone
(714) 972-3736
NPI assigned
Feb 21, 2019
Last updated
Apr 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 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 129110 CA Primary

Addresses

Primary practice location

4000 W Metropolitan Dr Ste 120
Orange, CA 92868-3504

Mailing address

4000 W Metropolitan Dr Ste 120
Orange, CA 92868-3504
Phone (714) 972-3736

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
I20250414000466 CA Practitioner - Marriage and Family Therapist 0648794545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of OrangeGroup PAC ID 1951215789, 45 clinicians

Practice addresses (Care Compare)

4000 W Metropolitan Dr
Suite 120
Orange, CA 92868-3504
Phone (714) 972-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Orange Current Accepting new patients
County of Orange CurrentSince Jan 9, 2025 Accepting new patients
County of Orange CurrentSince Jan 9, 2025 Accepting new patients

Locations

23228 Madero
Mission Viejo, CA 92691
Phone (949) 454-3940

4000 W Metropolitan Dr
Ste 120
Orange, CA 92868
Phone 7149723700 ext. 3710

Organizations & group practices 3

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": "1550707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1376000745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 W METROPOLITAN DR STE 120",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683504",
            "telephone_number": "714-972-3736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 W METROPOLITAN DR STE 120",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683504",
            "telephone_number": "714-972-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENTON",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-21",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "129110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.