Individual provider Active NPI

Charee Nicole Crisci

  • Marriage & Family Therapist
  • Fountain Valley, CA
National Provider Identifier
1508182148
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
100506 Issued in CA
Practice address
17330 Newhope St Ste a
Fountain Valley, CA 92708-4225
Phone
(626) 437-6127
NPI assigned
Apr 7, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Marriage & Family Therapist 106H00000X
Marriage & Family Therapist 106H00000X 100506 CA Primary

Addresses

Primary practice location

17330 Newhope St Ste a
Fountain Valley, CA 92708-4225

Mailing address

6652 Issac St
Chino, CA 91710-7336
Phone (626) 437-6127

Other practice location 1

15229 Amar Rd
LA Puente, CA 91744-2066
Phone (626) 855-5090

Other practice location 2

3700 Hathaway Ave
Long Beach, CA 90815-5110
Phone (626) 855-5090

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

LicenseStateTypeSpecialty
100506CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Charee Marquez LMFT, Professional Corporation Current Accepting new patients

Locations

17330 Newhope St
Ste A
Fountain Valley, CA 92708
Phone (844) 349-0077

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1270598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1508182148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6652 ISSAC ST",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917107336",
            "telephone_number": "626-437-6127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17330 NEWHOPE ST STE A",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084225",
            "telephone_number": "626-437-6127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15229 Amar Rd",
            "address_purpose": "LOCATION",
            "city": "LA Puente",
            "state": "CA",
            "postal_code": "917442066",
            "country_code": "US",
            "telephone_number": "626-855-5090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3700 Hathaway Ave",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908155110",
            "country_code": "US",
            "telephone_number": "626-855-5090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRISCI",
        "first_name": "CHAREE",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-07",
        "last_updated": "2024-07-10",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "100506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.