Stephen Thomas Prystash, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MF24093 Issued in CA

Practice address

28364 Vincent Moraga Dr
Temecula, CA 92590-3656

Phone

(951) 526-4118

Fax

(951) 602-6166

NPI assigned

Mar 26, 2010

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Southland Marriage and Family

  • Community/Behavioral Health Agency
  • Temecula, CA
  • NPI 1306211826
  NPD (past) Authorized official

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

{
    "created_epoch": "1269561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291852800000",
    "number": "1942524475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32654 VIA PERALES",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925928148",
            "telephone_number": "951-526-4118",
            "fax_number": "951-602-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28364 VINCENT MORAGA DR",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925903656",
            "telephone_number": "951-526-4118",
            "fax_number": "951-602-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRYSTASH",
        "first_name": "STEPHEN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-26",
        "last_updated": "2010-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MF24093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Temecula, CA
• Providers in Temecula, 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 Dec 9, 2010; 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.