Active NPI
Nicholas Green
- Marriage & Family Therapist
- Irvine, CA
National Provider Identifier
1700699873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 138043
- Practice address
- 19712 Macarthur Blvd Ste 110
Irvine, CA 92612-2407 - Phone
- (714) 912-9510
- NPI assigned
- Jan 30, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 138043 | CA | Primary |
Addresses
Primary practice location
19712 Macarthur Blvd Ste 110
Irvine, CA 92612-2407
Mailing address
5596 E Stetson CT
Anaheim, CA 92807-4649
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 138043 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738195200000",
"number": "1700699873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5596 E STETSON CT",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928074649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19712 MACARTHUR BLVD STE 110",
"city": "IRVINE",
"state": "CA",
"postal_code": "926122407",
"telephone_number": "714-912-9510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "NICHOLAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-01-30",
"last_updated": "2025-01-30",
"certification_date": "2025-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "138043",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.