Active NPI
Elijah Justin Bernales, MA, LMFT
- Marriage & Family Therapist
- Santa Ana, CA
National Provider Identifier
1760174486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 131492
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 Orange
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
| License | State | Type | Specialty |
|---|---|---|---|
| 131492 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Orange | Current | Accepting new patients | |
| County of Orange | Current | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Santa Ana, CA
- NPI 1104963347
CA
-
- Adult Mental Health Clinic/Center
- Santa Ana, CA
- NPI 1598025793
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.