Active NPI
Martin Miranda
- Marriage & Family Therapist
- Anaheim, CA
National Provider Identifier
1720824766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 147269
- Practice address
- 300 S Harbor Blvd Ste 910
Anaheim, CA 92805-3721 - Phone
- (714) 331-1191
- NPI assigned
- Jul 8, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 | 147269 | CA | Primary |
Addresses
Primary practice location
300 S Harbor Blvd Ste 910
Anaheim, CA 92805-3721
Mailing address
162 N Glassell St Ste C
Orange, CA 92866-1481
Phone (714) 331-1191
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 |
|---|---|---|---|
| 147269 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733356800000",
"number": "1720824766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "162 N GLASSELL ST STE C",
"city": "ORANGE",
"state": "CA",
"postal_code": "928661481",
"telephone_number": "714-331-1191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 S HARBOR BLVD STE 910",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928053721",
"telephone_number": "714-331-1191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRANDA",
"first_name": "MARTIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-07-08",
"last_updated": "2024-12-05",
"certification_date": "2024-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "147269",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.