Viviana McGovern, LMFT 136563

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

136563 Issued in CA

Practice address

21520 Yorba Linda Blvd Ste G
Yorba Linda, CA 92887-3764

Phone

(714) 485-7771

NPI assigned

Apr 20, 2020

Last updated

Aug 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Viviana McGovern LMFT, Individual, Marriage and Family Therapy, Inc.

  dba Full Vida Therapy

  • Community/Behavioral Health Agency
  • Yorba Linda, CA
  • NPI 1013696392
  NPD Authorized official

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

{
    "created_epoch": "1587340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1609496678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20409 YORBA LINDA BLVD # 163",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928863042",
            "telephone_number": "714-485-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21520 YORBA LINDA BLVD STE G",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928873764",
            "telephone_number": "714-485-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOVERN",
        "first_name": "VIVIANA",
        "credential": "LMFT 136563",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-20",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "136563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mbldn TMS PC (Mbldn Psychiatry & Wellness PC)
• Katherine Lynne McCarthy, PHARM D
• Kelly McDonald
• Matthew McGarvey, PA-C
• Douglas James McGavin, D.D.S.
• Andreea Ligia McIver, DO
• Ingrid Angela McManus, LCSW AND MFT
• Richard T McMillan, M.F.T.
• Amanda Meadows, BSN, RN
• Medical Center for Women

• Marriage & Family Therapist in Yorba Linda, CA
• Providers in Yorba Linda, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; 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.