John David Black Jr., MHRT

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

Practice address

2249 N.M Yale Street
Santa Ana, CA 91045

Phone

(323) 877-7303

NPI assigned

May 19, 2021

Sex

Male

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

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1649844176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634B EUCLID AVE",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910103110",
            "telephone_number": "323-877-7303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2249 N.M YALE STREET",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "91045",
            "telephone_number": "323-877-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MHRT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-05-19",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Edward Bittner, RN
• Cheryl Yague Bitun, LVN
• Angela Black
• Harold Steve Black, D.C.
• Jacy Leigh Black
• Jonathan William Black
• Julie Ann Black
• Michael Lewis Black, M.D.
• Sabrina Lee Blackney, D.P.T
• Denise Blair

• Counseling Psychologist in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Counseling Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.