Jacqueline Frye

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

122092 Issued in CA

Practice address

401 Imperial Hwy
Fullerton, CA 92835-1145

Phone

(714) 447-7000

NPI assigned

Jun 12, 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

Other names 1

• Jacqueline Liscano Former name

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

Specialty

Marriage and Family Therapist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of OrangeGroup PAC ID 1951215789, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• County of Orange

  dba Health Care Agency

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Santa Ana, CA
  • NPI 1104963347
  Medicare reassignment Care Compare group NPD
• County of Orange

  dba AMHS Crisis Stabilization Unit

  • Adult Mental Health Clinic/Center
  • Santa Ana, CA
  • NPI 1598025793
  NPD

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1851884118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 IMPERIAL HWY",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928351145",
            "telephone_number": "714-814-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 IMPERIAL HWY",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928351145",
            "telephone_number": "714-447-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14181 Telegraph Rd",
            "address_purpose": "LOCATION",
            "city": "Whittier",
            "state": "CA",
            "postal_code": "906042554",
            "country_code": "US",
            "telephone_number": "562-273-0722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRYE",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "122092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "LISCANO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Fruitful Therapy, Inc
• Christopher Fry
• Richard A Fry, PH.D.
• Amanda Frye, MSW
• Delione Marquise Frye
• Darlene Fuentes
• Jennifer Anne Fuentes, N.P.
• Collin Michael Fuhrman, PA-C
• Austin Derrik Fuller
• Earl S. Fuller, M.D.

• Marriage & Family Therapist in Fullerton, CA
• Providers in Fullerton, 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 Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.