Individual provider Active NPI

Ernesto Casasola Segismundo Jr., LMFT

  • Marriage & Family Therapist
  • Brea, CA
National Provider Identifier
1609918408
Registry record updated Oct 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC49640 Issued in CA
Practice address
915 W Imperial Hwy
Suite 150
Brea, CA 92821-3835
Phone
(909) 247-8820
NPI assigned
Feb 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2011

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 MFC49640 CA Primary

Addresses

Primary practice location

915 W Imperial Hwy
Suite 150
Brea, CA 92821-3835

Mailing address

9191 Enloe Way
Garden Grove, CA 92844-2707
Phone (909) 247-8820

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
MFC49640CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1609918408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9191 ENLOE WAY",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928442707",
            "telephone_number": "909-247-8820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 W IMPERIAL HWY",
            "address_2": "SUITE 150",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213835",
            "telephone_number": "909-247-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGISMUNDO",
        "first_name": "ERNESTO",
        "middle_name": "CASASOLA",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC49640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.