Jacqueline M Mack-Harris, PSYD, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

102490 Issued in CA

Practice address

41197 Golden Gate Cir Ste 207
Murrieta, CA 92562-6999

Phone

(951) 805-3467

NPI assigned

Sep 5, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Bridge Academy Collective

  dba The Bridge Advocacy and Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fullerton, CA
  • NPI 1790546125

  Marriage & Family Therapist

  NPD Authorized official
• The Bridge Marriage & Family Therapy

  • Community/Behavioral Health Agency
  • Brea, CA
  • NPI 1619613288
  NPD Authorized official
• Center for Individual and Family Therapy

  • Marriage & Family Therapist
  • Santa Ana, CA
  • NPI 1124470232
  NPD (past)

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

{
    "created_epoch": "1536105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1720560709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19917 CRESTWOOD DR",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925300400",
            "telephone_number": "949-275-2979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41197 GOLDEN GATE CIR STE 207",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925626999",
            "telephone_number": "951-805-3467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19917 Crestwood Dr",
            "address_purpose": "LOCATION",
            "city": "Lake Elsinore",
            "state": "CA",
            "postal_code": "925300400",
            "country_code": "US",
            "telephone_number": "949-275-2979",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 Nutwood Ave",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928313102",
            "country_code": "US",
            "telephone_number": "714-879-3901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "840 W Town and Country Rd",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928684712",
            "country_code": "US",
            "telephone_number": "714-558-9266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACK-HARRIS",
        "first_name": "JACQUELINE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSYD, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-05",
        "last_updated": "2022-04-01",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "102490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• M K Awwad DDS Inc
• M. H. Peters & Associates, Inc. (A Plus Murrieta Medical Supply)
• Kinnedy Macias
• Marisa Macias
• Linda A Macinnes
• Christopher Clayton Mackinney
• Armin Shariat Madari, DO, MPH
• Cynthia Maddox-Sanchez, MA CCC-SLP
• Aimara Alejandra Madero Durazo
• Vanessa Madrid

• Marriage & Family Therapist in Murrieta, CA
• Providers in Murrieta, 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 1, 2022; 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.