Individual provider Active NPI

Leslie J. Chegwidden, PH.D., MFT

  • Marriage & Family Therapist
  • Corona, CA
National Provider Identifier
1619021946
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT28711 Issued in CA
Practice address
1451 S. Rimpau
Suite 207
Corona, CA 92879
Phone
(951) 736-0727
Fax
(951) 736-0220
NPI assigned
Jan 23, 2007
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 MFT28711 CA Primary

Addresses

Primary practice location

1451 S. Rimpau
Suite 207
Corona, CA 92879

Mailing address

1451 S. Rimpau
Suite 207
Corona, CA 92879
Phone (951) 736-0727

Other identifiers 1

IdentifierTypeStateIssuer
MFT28711OtherCAMARRIAGE FAMILY LICENSE

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MFT28711CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619021946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 S. RIMPAU",
            "address_2": "SUITE 207",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "92879",
            "telephone_number": "951-736-0727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 S. RIMPAU",
            "address_2": "SUITE 207",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "92879",
            "telephone_number": "951-736-0727",
            "fax_number": "951-736-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEGWIDDEN",
        "first_name": "LESLIE",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "PH.D., MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT28711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARRIAGE FAMILY LICENSE",
            "identifier": "MFT28711",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, 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.