Individual provider Active NPI

Amanda Lynn Rogers

  • Marriage & Family Therapist
  • Tustin, CA
National Provider Identifier
1740152404
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
157244 Issued in CA
Practice address
17772 Irvine Blvd Ste 209
Tustin, CA 92780-3234
Phone
(714) 388-6119
NPI assigned
Sep 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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 157244 CA Primary

Addresses

Primary practice location

17772 Irvine Blvd Ste 209
Tustin, CA 92780-3234

Mailing address

17772 Irvine Blvd Ste 209
Tustin, CA 92780-3234
Phone (714) 388-6119

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
157244CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Moxie Family Therapy, PC Marriage & Family Therapist CurrentSince Sep 28, 2025 Accepting new patients

Locations

17772 Irvine Blvd
Ste 209
Tustin, CA 92780
Phone (714) 388-6119

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1758499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1740152404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17772 IRVINE BLVD STE 209",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803234",
            "telephone_number": "714-388-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17772 IRVINE BLVD STE 209",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803234",
            "telephone_number": "714-388-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-22",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "157244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; 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.