Marilyn L. Tudor Bleak, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC46562 Issued in CA

Practice address

2900 Bristol Street
Suite J101
Costa Mesa, CA 92626

Phone

(949) 300-5228

Fax

(949) 833-1797

NPI assigned

Jun 11, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Ms. Marilyn L. Tudor Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1730400862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 18325",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926239998",
            "telephone_number": "949-300-5228",
            "fax_number": "949-833-1797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 BRISTOL STREET",
            "address_2": "SUITE J101",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "92626",
            "telephone_number": "949-300-5228",
            "fax_number": "949-833-1797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUDOR BLEAK",
        "first_name": "MARILYN",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-11",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC46562",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC4656Z",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARILYN",
            "last_name": "TUDOR",
            "middle_name": "L.",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Yuka Tsukioka, N.M.D.
• Lily Frances Tsutsumida, LMFT, ATR-BC
• Linken Tu, CMT
• Trina Tuazon
• Samuel Tuc
• Kari Ann Tuggle-Nord, LCSW, RD
• Fangel Tung
• Choral Tunson
• Taulau Nicolas Tupua
• Michelle Turgeon

• Marriage & Family Therapist in Costa Mesa, CA
• Providers in Costa Mesa, 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 Sep 1, 2010; 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.