Individual provider Active NPI

Wade Justin Denes, LMFT

  • Marriage & Family Therapist
  • San Clemente, CA
National Provider Identifier
1841897725
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
122269 Issued in CA
Practice address
1302 S El Camino Real # a-3
San Clemente, CA 92672-4290
Phone
(760) 237-8469
NPI assigned
Oct 5, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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 122269 CA Primary

Addresses

Primary practice location

1302 S El Camino Real # a-3
San Clemente, CA 92672-4290

Mailing address

5443 Gooseberry Way
Oceanside, CA 92057-4638
Phone (818) 212-5881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240523002065 CA Practitioner - Marriage and Family Therapist 4981046893 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
122269CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Marriage & Family Therapist CurrentSince Apr 12, 2024 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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": "1601856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1841897725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5443 GOOSEBERRY WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920574638",
            "telephone_number": "818-212-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 S EL CAMINO REAL # A-3",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724290",
            "telephone_number": "760-237-8469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENES",
        "first_name": "WADE",
        "middle_name": "JUSTIN",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-05",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "122269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.