NPIMap

Organization Active NPI

Pacific Marriage & Family Therapy Network, a Professional Corporation

Doing business as Pacific MFT Network

  • Marriage & Family Therapist
  • Santa Monica, CA
National Provider Identifier
1558720904
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
53455 Issued in CA
Legal business name
PACIFIC MARRIAGE & FAMILY THERAPY NETWORK, A PROFESSIONAL CORPORATION
Doing business as
Pacific MFT Network
Practice address
2716 Ocean Park Blvd Ste 3075
Santa Monica, CA 90405-5232
Phone
(310) 612-2998
NPI assigned
Feb 14, 2016
Last updated
May 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Authorized official

Name
Tracy Kovacs Bevington, MA, MFTNPI 1073913745
Title
President
Phone
(310) 226-2826

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 53455 CA Primary

Addresses

Primary practice location

2716 Ocean Park Blvd Ste 3075
Santa Monica, CA 90405-5232

Mailing address

2716 Ocean Park Blvd Ste 3075
Santa Monica, CA 90405-5232
Phone (310) 612-2998

Other names 1

  • Pacific MFT Network Doing business as

National Provider Directory

National Provider Directory

Locations

2716 Ocean Park Blvd
Ste 3075CA
Santa Monica, CA 90405

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1455408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1558720904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2716 OCEAN PARK BLVD STE 3075",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904055232",
            "telephone_number": "310-612-2998",
            "fax_number": "310-943-2590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2716 OCEAN PARK BLVD STE 3075",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904055232",
            "telephone_number": "310-612-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC MARRIAGE & FAMILY THERAPY NETWORK, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-14",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "BEVINGTON",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "KOVACS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-226-2826",
        "authorized_official_credential": "MA, MFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "53455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific MFT Network",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pacific MFT Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.