Individual provider Active NPI

Christine D McIlwain, MFT

  • Marriage & Family Therapist
  • Santa Ana, CA
National Provider Identifier
1558450734
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
M13424 Issued in CA
Practice address
1725 W 17TH St
Santa Ana, CA 92706-2316
Phone
(714) 834-7926
Fax
(714) 834-8235
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 M13424 CA Primary

Addresses

Primary practice location

1725 W 17TH St
Santa Ana, CA 92706-2316

Mailing address

PO Box 10671
Newport Beach, CA 92658-5004
Phone (714) 834-7926

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
M13424CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558450734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10671",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926585004",
            "telephone_number": "714-834-7926",
            "fax_number": "714-834-8235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927062316",
            "telephone_number": "714-834-7926",
            "fax_number": "714-834-8235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCILWAIN",
        "first_name": "CHRISTINE",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "M13424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.