Individual provider Active NPI

Jeannie Colvin, MFT

  • Marriage & Family Therapist
  • Newport Beach, CA
National Provider Identifier
1407947328
Registry record updated Jul 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC42477 Issued in CA
Practice address
1000 Quail St
Suite 240
Newport Beach, CA 92660-2731
Phone
(949) 241-0042
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2016

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 MFC42477 CA Primary

Addresses

Primary practice location

1000 Quail St
Suite 240
Newport Beach, CA 92660-2731

Mailing address

1000 Quail St
Suite 240
Newport Beach, CA 92660-2731
Phone (949) 241-0042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC42477CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468540800000",
    "number": "1407947328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 QUAIL ST",
            "address_2": "SUITE 240",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602731",
            "telephone_number": "949-241-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 QUAIL ST",
            "address_2": "SUITE 240",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602731",
            "telephone_number": "949-241-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLVIN",
        "first_name": "JEANNIE",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2016-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC42477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.