Christina W Vescovo, MFT ASSOCIATE

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

105030 Issued in CA

Practice address

22809 Pacific Coast Hwy
Malibu, CA 90265-5873

Phone

(424) 346-2999

NPI assigned

Jul 18, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1780160127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 VISTA PACIFICA UNIT 10",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902654832",
            "telephone_number": "131-474-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22809 PACIFIC COAST HWY",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902655873",
            "telephone_number": "424-346-2999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "837 E Thompson Blvd",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930012917",
            "country_code": "US",
            "telephone_number": "424-346-2999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VESCOVO",
        "first_name": "CHRISTINA",
        "middle_name": "W",
        "name_prefix": "Ms.",
        "credential": "MFT ASSOCIATE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "105030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Malibu, CA
• Providers in Malibu, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.