Active NPI
Judith Atsumi Nishimori, LMFT
- Professional Counselor
- Santa Maria, CA
National Provider Identifier
1770652778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- MFT25732
- Practice address
- 105 N Lincoln St
Santa Maria, CA 93458-4319 - Phone
- (808) 928-1707
- Fax
- (805) 922-4797
- NPI assigned
- Nov 6, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | MFT25732 | CA | Primary |
Addresses
Primary practice location
105 N Lincoln St
Santa Maria, CA 93458-4319
Mailing address
105 N Lincoln St
Santa Maria, CA 93458-4319
Phone (808) 928-1707
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 11, 2024 through Mar 11, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT25732 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770652778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 N LINCOLN ST",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "934584319",
"telephone_number": "808-928-1707",
"fax_number": "805-922-4797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 N LINCOLN ST",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "934584319",
"telephone_number": "808-928-1707",
"fax_number": "805-922-4797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NISHIMORI",
"first_name": "JUDITH",
"middle_name": "ATSUMI",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "MFT25732",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Maria, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.