Jyoti Mallika Gustafson, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

122101 Issued in CA

Practice address

615 W Civic Center Dr Ste 200
Santa Ana, CA 92701-4052

Phone

(714) 795-3444

Fax

(714) 795-3445

NPI assigned

Mar 9, 2011

Sex

Female

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Telecare Corporation

  dba Gateway To Recovery

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Diego, CA
  • NPI 1720164882
  Medicare reassignment NPD
• Telecare Corporation

  dba Valley Vista Permanent Supportive Housing

  • Mental Illness Community Based Residential Treatment Facility
  • San Diego, CA
  • NPI 1275398935
  NPD
• Telecare Corporation

  dba AMHS Telecare TREEhouse Crisis Residential South

  • Psychiatric Residential Treatment Facility
  • Mission Viejo, CA
  • NPI 1942737648
  NPD
• Telecare Corporation

  dba Amhs Telecare Aot FSP

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Santa Ana, CA
  • NPI 1245627199
  NPD (past)

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

{
    "created_epoch": "1299628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1700184124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 W CIVIC CENTER DR STE 200",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014052",
            "telephone_number": "714-795-3444",
            "fax_number": "714-795-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 W CIVIC CENTER DR STE 200",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014052",
            "telephone_number": "714-795-3444",
            "fax_number": "714-795-3445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "JYOTI",
        "middle_name": "MALLIKA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-09",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "122101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abha S Gupta, M.D.
• Mrinali Patel Gupta, M.D.
• Amy Marie Gurevitz, PA-C
• Maria Jacqueline Gurrola, LVN
• Octavio Gurrola
• Kevin Mitsutoshi Gustafson, MD
• Sean Guthrie
• Josefina Gutierrez de Roman, R.N.
• Gutierrez Espinoza Physician Assistant Corp
• Lesley Joseline Gutierrez- Hernandez

• Marriage & Family Therapist in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.