Individual provider Active NPI

Maryann Kubicek, MFT

  • Marriage & Family Therapist
  • Santa Ana, CA
National Provider Identifier
1700977717
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC35773 Issued in CA
Practice address
405 W 5TH St
Suite 550
Santa Ana, CA 92701-4519
Phone
(714) 567-7636
Fax
(714) 834-6825
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

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 MFC35773 CA Primary

Addresses

Primary practice location

405 W 5TH St
Suite 550
Santa Ana, CA 92701-4519

Mailing address

5318 E 2ND St # 196
Long Beach, CA 90803-5324
Phone (562) 986-7473

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

LicenseStateTypeSpecialty
MFC35773CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700977717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5318 E 2ND ST # 196",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908035324",
            "telephone_number": "562-986-7473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W 5TH ST",
            "address_2": "SUITE 550",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014519",
            "telephone_number": "714-567-7636",
            "fax_number": "714-834-6825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBICEK",
        "first_name": "MARYANN",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC35773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.