Individual provider Active NPI

Nicole Summer McCuistion, MFT

  • Marriage & Family Therapist
  • Anaheim, CA
National Provider Identifier
1790794105
Registry record updated Nov 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC42478 Issued in CA
Practice address
131 W Midway Dr
Anaheim, CA 92805-6507
Phone
(714) 517-7107
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2010

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 MFC42478 CA Primary

Addresses

Primary practice location

131 W Midway Dr
Anaheim, CA 92805-6507

Mailing address

131 W Midway Dr
Anaheim, CA 92805-6507
Phone (714) 717-3711

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290470400000",
    "number": "1790794105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 W MIDWAY DR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928056507",
            "telephone_number": "714-717-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 W MIDWAY DR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928056507",
            "telephone_number": "714-517-7107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCUISTION",
        "first_name": "NICOLE",
        "middle_name": "SUMMER",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2010-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC42478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; 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.