Active NPI
Jacqueline Ann Hayes, MFT
- Marriage & Family Therapist
- Costa Mesa, CA
National Provider Identifier
1669715918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 50113
- Practice address
- 2134 Continental Ave
Costa Mesa, CA 92627-3312 - Phone
- (949) 631-6129
- NPI assigned
- Apr 4, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 260 | CA | |
| Marriage & Family Therapist | 106H00000X | 50113 | CA | Primary |
Addresses
Primary practice location
2134 Continental Ave
Costa Mesa, CA 92627-3312
Mailing address
2134 Continental Ave
Costa Mesa, CA 92627-3312
Phone (949) 631-6129
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2003
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Suite 602060
San Diego, CA 92160
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50113 | CA | MD | Marriage & Family Therapist |
| 260 | CA | MD | Dental Hygienist |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- San Diego, CA
- NPI 1649064486
-
- Psychiatry Physician
- San Jose, CA
- NPI 1942935473
-
- Mental Health Counselor
- San Diego, CA
- NPI 1942970330
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365033600000",
"number": "1669715918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2134 CONTINENTAL AVE",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926273312",
"telephone_number": "949-631-6129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2134 CONTINENTAL AVE",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926273312",
"telephone_number": "949-631-6129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYES",
"first_name": "JACQUELINE",
"middle_name": "ANN",
"name_prefix": "Miss",
"credential": "MFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-04",
"last_updated": "2013-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "260",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "50113",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.