Active NPI
Marc Allan Blake
- Marriage & Family Therapist
- Newport Beach, CA
National Provider Identifier
1508701103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 124380
- Practice address
- 4019 Westerly PL Ste 102
Newport Beach, CA 92660-2333 - Phone
- (714) 540-9070
- NPI assigned
- Apr 21, 2026
- 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 | 124380 | CA | Primary |
Addresses
Primary practice location
4019 Westerly PL Ste 102
Newport Beach, CA 92660-2333
Mailing address
4019 Westerly PL Ste 102
Newport Beach, CA 92660-2333
Phone (714) 540-9070
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 |
|---|---|---|---|
| 124380 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777334400000",
"number": "1508701103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4019 WESTERLY PL STE 102",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926602333",
"telephone_number": "714-540-9070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4019 WESTERLY PL STE 102",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926602333",
"telephone_number": "714-540-9070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKE",
"first_name": "MARC",
"middle_name": "ALLAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-04-21",
"last_updated": "2026-04-28",
"certification_date": "2026-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "124380",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.