Active NPI
Jeffrey Randall Wirth, MFT
- Marriage & Family Therapist
- Colton, CA
National Provider Identifier
1447424031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC30166
- Practice address
- 1461 E Cooley Dr Ste 100
Colton, CA 92324-3921 - Phone
- (877) 761-4963
- NPI assigned
- Apr 15, 2008
- Sex
- Male
- 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 | MFC30166 | CA | Primary |
Addresses
Primary practice location
1461 E Cooley Dr Ste 100
Colton, CA 92324-3921
Mailing address
25910 Acero Ste 160
Mission Viejo, CA 92691-2777
Phone (877) 761-4963
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
| License | State | Type | Specialty |
|---|---|---|---|
| MFC30166 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740787200000",
"number": "1447424031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25910 ACERO STE 160",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926912777",
"telephone_number": "877-761-4963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1461 E COOLEY DR STE 100",
"city": "COLTON",
"state": "CA",
"postal_code": "923243921",
"telephone_number": "877-761-4963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIRTH",
"first_name": "JEFFREY",
"middle_name": "RANDALL",
"name_prefix": "Mr.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-15",
"last_updated": "2025-03-01",
"certification_date": "2025-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC30166",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.