Individual provider Active NPI

Krissy Marie Thomas

  • Marriage & Family Therapist
  • Fountain Valley, CA
National Provider Identifier
1740979921
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
145396 Issued in CA
Practice address
9806 Shriner Cir
Fountain Valley, CA 92708-3537
Phone
(562) 444-5031
NPI assigned
May 3, 2023
Last updated
Apr 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Marriage & Family Therapist 106H00000X 145396 CA Primary

Addresses

Primary practice location

9806 Shriner Cir
Fountain Valley, CA 92708-3537

Mailing address

27130 Paseo Espada Ste 522
San Juan Capistrano, CA 92675-2719

Other practice location 1

224 Sage Thrasher Cir
Dripping Springs, TX 78620-2785
Phone (562) 444-5031

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
145396CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Village Wellness Center, a Family Counseling Corporation Marriage & Family Therapist CurrentSince May 1, 2023 Accepting new patients

Locations

27130 Paseo Espada
Ste 522
San Juan Capistrano, CA 92675
Phone (310) 613-2236

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1740979921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27130 PASEO ESPADA STE 522",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926752719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9806 SHRINER CIR",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083537",
            "telephone_number": "562-444-5031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "224 Sage Thrasher Cir",
            "address_purpose": "LOCATION",
            "city": "Dripping Springs",
            "state": "TX",
            "postal_code": "786202785",
            "country_code": "US",
            "telephone_number": "562-444-5031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KRISSY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-03",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "145396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.

Verify at the official NPI Registry.