Individual provider Active NPI

Nubia Hennessey, M.A.

  • Marriage & Family Therapist
  • Tustin, CA
National Provider Identifier
1861676587
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
53896 Issued in CA
Practice address
18302 Irvine Blvd Ste 375
Tustin, CA 92780-3435
Phone
(714) 661-5390
NPI assigned
Dec 18, 2007
Last updated
Mar 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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 53896 CA Primary

Addresses

Primary practice location

18302 Irvine Blvd Ste 375
Tustin, CA 92780-3435

Mailing address

18302 Irvine Blvd Ste 375
Tustin, CA 92780-3435
Phone (714) 661-5390

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
I20240306002892 CA Practitioner - Marriage and Family Therapist 7719323294 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
53896CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
College Community Services Current Accepting new patients
Grow Healthcare Group PC Marriage & Family Therapist CurrentSince Jan 27, 2026 Accepting new patients
College Community Services CurrentSince Jan 20, 2024 Accepting new patients
College Community Services CurrentSince Jan 20, 2024 Accepting new patients

Locations

1855 W Katella Ave
Ste 150
Orange, CA 92867
Phone (714) 399-3480

8337 Telegraph Rd
Ste 300
Pico Rivera, CA 90660
Phone (562) 207-4272

2001 E 4th St
Ste 200
Santa Ana, CA 92705
Phone (714) 474-3807

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1861676587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18302 IRVINE BLVD STE 375",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803435",
            "telephone_number": "714-661-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18302 IRVINE BLVD STE 375",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803435",
            "telephone_number": "714-661-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSEY",
        "first_name": "NUBIA",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-18",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "53896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.