Individual provider Active NPI

Elijah Justin Bernales, MA, LMFT

  • Marriage & Family Therapist
  • Santa Ana, CA
National Provider Identifier
1760174486
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
131492 Issued in CA
Practice address
405 W 5TH St
Santa Ana, CA 92701-4599
Phone
(714) 834-3101
NPI assigned
May 22, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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 131492 CA Primary

Addresses

Primary practice location

405 W 5TH St
Santa Ana, CA 92701-4599

Mailing address

405 W 5TH St
Santa Ana, CA 92701-4599
Phone (714) 308-5473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251022003010 CA Practitioner - Marriage and Family Therapist 4183112048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of OrangeGroup PAC ID 1951215789, 45 clinicians

Practice addresses (Care Compare)

401 W Civic Ctr Dr
Suite 600
Santa Ana, CA 92701-4515
Phone (714) 480-6767

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
131492CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Orange Current Accepting new patients
County of Orange CurrentSince Aug 8, 2025 Accepting new patients

Locations

23228 Madero
Mission Viejo, CA 92691
Phone (949) 454-3940

401 W Civic Center Dr
Ste 600
Santa Ana, CA 92701
Phone (626) 429-0299

Organizations & group practices 2

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": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1760174486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W 5TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014599",
            "telephone_number": "714-308-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W 5TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014599",
            "telephone_number": "714-834-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNALES",
        "first_name": "ELIJAH",
        "middle_name": "JUSTIN",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "131492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.