Family Legacy Therapy Professional Corporation

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

FAMILY LEGACY THERAPY PROFESSIONAL CORPORATION

Practice address

1350 W Robinhood Dr Ste 7
Stockton, CA 95207-5519

Phone

(209) 645-1994

NPI assigned

May 25, 2022

Organization subpart

No

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

Authorized official

Name

San Juana Melgoza, LMFTNPI 1316328792

Title

Ceo

Phone

(209) 298-0510

Specialties & licenses 1

Addresses

Other names 1

• Family Legacy Therapy Professional Corporation Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• San Juana Melgoza, LMFT

  • Marriage & Family Therapist
  • Stockton, CA
  • NPI 1316328792
  NPD Authorized official

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1730827023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 W ROBINHOOD DR STE 7",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075519",
            "telephone_number": "209-645-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 W ROBINHOOD DR STE 7",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075519",
            "telephone_number": "209-645-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY LEGACY THERAPY PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-25",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "MELGOZA",
        "authorized_official_first_name": "SAN JUANA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-298-0510",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Legacy Therapy Professional Corporation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sadaf Fakharzadeh
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• Family Support Home Care LLC
• Famlinc Mobile Labs LLC

• Marriage & Family Therapist in Stockton, CA
• Providers in Stockton, 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 May 25, 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.