Sara Kumasaka Matsuda

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPCC18012 Issued in CA

Practice address

23461 S Pointe Dr Ste 100
Laguna Hills, CA 92653-1523

Phone

(949) 452-0888

Fax

(949) 452-0889

NPI assigned

Dec 8, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shanti Orange CountyGroup PAC ID 9537475736, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Shanti Orange County

  • Adult Mental Health Clinic/Center
  • Laguna Hills, CA
  • NPI 1447656418
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1670457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1548971716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14019 SAN SEGUNDO DR",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917392150",
            "telephone_number": "801-946-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23461 S POINTE DR STE 100",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531523",
            "telephone_number": "949-452-0888",
            "fax_number": "949-452-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMASAKA MATSUDA",
        "first_name": "SARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-08",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LPCC18012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OUTPATIENT MENTAL HEALTH",
            "identifier": "101YP2500X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Aguirre, MD Inc
• Edwin Andrew Krone, HEARING AID DISPENSE
• Martin Paul Kruger, DDS
• Diala Kseibi, DDS
• Samantha Mehta Kubaska, M.D.
• Kwon Endodontics, Apc
• Robert Sung Gil Kwon, MD
• Sophia Kwong, RPH
• Kyung Myun Kim DDS Corporation
• L. Hamilton MFT, Inc.

• Mental Health Counselor in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.