Individual provider Active NPI

Sophie Kubichek, LMFT

  • Marriage & Family Therapist
  • Corona del Mar, CA
National Provider Identifier
1881255537
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
113581 Issued in CA
Practice address
2721 E Coast Hwy Ste 209
Corona del Mar, CA 92625-2131
Phone
(949) 478-4147
NPI assigned
Jun 24, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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 113581 CA Primary

Addresses

Primary practice location

2721 E Coast Hwy Ste 209
Corona del Mar, CA 92625-2131

Mailing address

PO Box 9622
Newport Beach, CA 92658-9622
Phone (949) 478-4147

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
113581CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1881255537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9622",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926589622",
            "telephone_number": "949-478-4147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2721 E COAST HWY STE 209",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926252131",
            "telephone_number": "949-478-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBICHEK",
        "first_name": "SOPHIE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "113581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona del Mar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; 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.