Individual provider Active NPI

Liquita Shatoro Dage, LMFT

  • Marriage & Family Therapist
  • Irvine, CA
National Provider Identifier
1649986597
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
135627 Issued in CA
Practice address
4040 Barranca Pkwy Ste 260
Irvine, CA 92604-4780
Phone
(925) 282-1778
Fax
(415) 296-5299
NPI assigned
Jan 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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 135627 CA Primary

Addresses

Primary practice location

4040 Barranca Pkwy Ste 260
Irvine, CA 92604-4780

Mailing address

4040 Barranca Pkwy Ste 260
Irvine, CA 92604-4780
Phone (925) 282-1778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250409000727 CA Practitioner - Marriage and Family Therapist 4486178639

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1674518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1649986597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 BARRANCA PKWY STE 260",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044780",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 BARRANCA PKWY STE 260",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044780",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGE",
        "first_name": "LIQUITA",
        "middle_name": "SHATORO",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-24",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "135627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.