NPIMap

Organization Active NPI

Moxie Family Therapy, PC

  • Marriage & Family Therapist
  • Tustin, CA
National Provider Identifier
1962006486
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
MOXIE FAMILY THERAPY, PC
Doing business as
Moxie Family Therapy, PC
Practice address
17772 Irvine Blvd Ste 209
Tustin, CA 92780-3234
Phone
(714) 388-6119
NPI assigned
Nov 24, 2020
Last updated
Aug 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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

Authorized official

Name
Melissa Ann Mellon, LMFTNPI 1215084041
Title
Founder and Director
Phone
(714) 388-6119

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

17772 Irvine Blvd Ste 209
Tustin, CA 92780-3234

Mailing address

17772 Irvine Blvd Ste 209
Tustin, CA 92780-3234
Phone (714) 388-6119

Other names 1

  • Moxie Family Therapy, PC Doing business as

National Provider Directory

National Provider Directory

Locations

17772 Irvine Blvd
Ste 209
Tustin, CA 92780
Phone (714) 388-6119

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1606176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660694400000",
    "number": "1962006486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17772 IRVINE BLVD STE 209",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803234",
            "telephone_number": "714-388-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17772 IRVINE BLVD STE 209",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803234",
            "telephone_number": "714-388-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOXIE FAMILY THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-24",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A",
        "authorized_official_last_name": "MELLON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "FOUNDER AND DIRECTOR",
        "authorized_official_telephone_number": "714-388-6119",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moxie Family Therapy, PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Moxie Family Therapy, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; 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.