Individual provider Active NPI

Geoffrey Richard Wrenn, M.A.

  • Marriage & Family Therapist
  • Fountain Valley, CA
National Provider Identifier
1790214666
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
112671 Issued in CA
Practice address
18430 Brookhurst St Ste 201F
Fountain Valley, CA 92708-6757
Phone
(714) 851-9245
Fax
(714) 526-1247
NPI assigned
Jun 5, 2017
Last updated
Dec 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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 112671 CA Primary

Addresses

Primary practice location

18430 Brookhurst St Ste 201F
Fountain Valley, CA 92708-6757

Mailing address

18430 Brookhurst St Ste 201F
Fountain Valley, CA 92708-6757
Phone (714) 851-9245

Other practice location 1

9042 Garfield Ave Ste 207
Huntington Beach, CA 92646-2351
Phone (714) 851-9245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
112671CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1790214666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18430 BROOKHURST ST STE 201F",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086757",
            "telephone_number": "714-851-9245",
            "fax_number": "714-526-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18430 BROOKHURST ST STE 201F",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086757",
            "telephone_number": "714-851-9245",
            "fax_number": "714-526-1247"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9042 Garfield Ave Ste 207",
            "address_purpose": "LOCATION",
            "city": "Huntington Beach",
            "state": "CA",
            "postal_code": "926462351",
            "country_code": "US",
            "telephone_number": "714-851-9245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WRENN",
        "first_name": "GEOFFREY",
        "middle_name": "RICHARD",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-05",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "112671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.