Organization Active NPI

Golden State Marrriage and Family Therapy a Professional Corporation

  • Mental Health Counselor
  • Tustin, CA
National Provider Identifier
1750040499
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
GOLDEN STATE MARRRIAGE AND FAMILY THERAPY A PROFESSIONAL CORPORATION
Practice address
515 E 1St St Ste D
Tustin, CA 92780-3335
Phone
(657) 900-8655
Fax
(657) 900-8656
NPI assigned
Dec 9, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Authorized official

Name
Janet C BasaloneNPI 1053664649
Title
President/Owner
Phone
(657) 900-8655

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

515 E 1St St Ste D
Tustin, CA 92780-3335

Mailing address

250 El Camino Real Ste 213
Tustin, CA 92780-3656
Phone (657) 900-8655

Other names 2

  • Golden State Therapy Doing business as
  • Golden State Therapy, Inc Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260216002577 CA Part B Supplier - Clinic/Group Practice 4385124635 Receives reassigned benefits from 1 practitioner
Practice locations: Tustin, CA

National Provider Directory

National Provider Directory

Locations

515 E 1st St
Ste D
Tustin, CA 92780
Phone (657) 900-8655

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1639008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769040000000",
    "number": "1750040499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 EL CAMINO REAL STE 213",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803656",
            "telephone_number": "657-900-8655",
            "fax_number": "657-900-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 E 1ST ST STE D",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803335",
            "telephone_number": "657-900-8655",
            "fax_number": "657-900-8656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN STATE MARRRIAGE AND FAMILY THERAPY A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-09",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A",
        "authorized_official_last_name": "BASALONE",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "657-900-8655"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Golden State Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Golden State Therapy, Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.