Individual provider Active NPI

Victoria Wallace Schlicht, MA, LMFT

  • Marriage & Family Therapist
  • Tustin, CA
National Provider Identifier
1790905172
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 43043 Issued in CA
Practice address
14181 Yorba St Ste 208
Tustin, CA 92780-2055
Phone
(714) 914-5565
Fax
(714) 734-4266
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MFC 43043 CA Primary

Addresses

Primary practice location

14181 Yorba St Ste 208
Tustin, CA 92780-2055

Mailing address

14181 Yorba St Ste 208
Tustin, CA 92780-2055
Phone (714) 914-5565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MFC 43043CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Transforming Hearts Somatic Therapy Marriage & Family Therapist CurrentSince May 16, 2022 Accepting new patients

Locations

1151 Dove St
Ste 285
Newport Beach, CA 92660
Phone (714) 914-5565

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790905172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14181 YORBA ST STE 208",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802055",
            "telephone_number": "714-914-5565",
            "fax_number": "714-734-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14181 YORBA ST STE 208",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802055",
            "telephone_number": "714-914-5565",
            "fax_number": "714-734-4266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLICHT",
        "first_name": "VICTORIA",
        "middle_name": "WALLACE",
        "name_prefix": "Ms.",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 43043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.