Individual provider Active NPI

Elisabeth Farnsworth, MA

  • Marriage & Family Therapist
  • Tustin, CA
National Provider Identifier
1689710105
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 40872 Issued in CA
Practice address
515 E 1St St
Tustin, CA 92780-3335
Phone
(949) 246-5062
Fax
(714) 378-9741
NPI assigned
Jan 30, 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 MFC 40872 CA Primary

Addresses

Primary practice location

515 E 1St St
Tustin, CA 92780-3335

Mailing address

10449 Thrush Ave
Fountain Valley, CA 92708-7106
Phone (714) 379-9740

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241205002562 CA Practitioner - Marriage and Family Therapist 6901332584 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC 40872CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cyti Health PC CurrentSince Oct 3, 2024 Accepting new patients

Locations

11801 Pierce St
Riverside, CA 92505
Phone (909) 528-0317

3111 Camino del Rio N
Ste 460
San Diego, CA 92108

402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689710105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10449 THRUSH AVE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087106",
            "telephone_number": "714-379-9740",
            "fax_number": "714-378-9741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 E 1ST ST",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803335",
            "telephone_number": "949-246-5062",
            "fax_number": "714-378-9741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARNSWORTH",
        "first_name": "ELISABETH",
        "name_prefix": "Ms.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 40872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.