Individual provider Active NPI

Julie Mancia Fortune, M.S.

  • Marriage & Family Therapist
  • Fullerton, CA
National Provider Identifier
1376685974
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 48831 Issued in CA
Practice address
1835 Sunny Crest Dr
Fullerton, CA 92835
Phone
(714) 446-5101
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1227 TN
Marriage & Family Therapist 106H00000X MFC 48831 CA Primary

Addresses

Primary practice location

1835 Sunny Crest Dr
Fullerton, CA 92835

Mailing address

2120 Belcourt Ave
Nashville, TN 37212-3504
Phone (615) 936-0336

Other practice location 1

2120 Belcourt Ave
Nashville, TN 37212-3504
Phone (615) 936-0336

Other names 1

  • Ms. Julie Mancia Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MFC 48831CAMDMarriage & Family Therapist
1227TNMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1376685974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 BELCOURT AVE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372123504",
            "telephone_number": "615-936-0336",
            "fax_number": "615-936-0352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 SUNNY CREST DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "92835",
            "telephone_number": "714-446-5101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2120 Belcourt Ave",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372123504",
            "country_code": "US",
            "telephone_number": "615-936-0336",
            "fax_number": "615-936-0352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORTUNE",
        "first_name": "JULIE",
        "middle_name": "MANCIA",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TN",
            "license": "1227",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 48831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "MANCIA",
            "prefix": "MS.",
            "credential": "M.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.