Active NPI
Kevin Jacob Regan
- Marriage & Family Therapist
- Costa Mesa, CA
National Provider Identifier
1962918243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 2900 Bristol St Ste C208
Costa Mesa, CA 92626-5946 - Phone
- (949) 232-0748
- NPI assigned
- Dec 21, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Marriage & Family Therapist | 106H00000X | CA | Primary |
Addresses
Primary practice location
2900 Bristol St Ste C208
Costa Mesa, CA 92626-5946
Mailing address
2900 Bristol St Ste C208
Costa Mesa, CA 92626-5946
Other practice location 1
26137 La Paz Rd Ste 230
Mission Viejo, CA 92691-5337
Phone (949) 595-8610
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Feb 1, 2024 through Feb 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Youth Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Adolescent and Children Mental Health Clinic/Center
- Mission Viejo, CA
- NPI 1790817468
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656633600000",
"number": "1962918243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2900 BRISTOL ST STE C208",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926265946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 BRISTOL ST STE C208",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926265946",
"telephone_number": "949-232-0748"
}
],
"practiceLocations": [
{
"address_1": "26137 La Paz Rd Ste 230",
"address_purpose": "LOCATION",
"city": "Mission Viejo",
"state": "CA",
"postal_code": "926915337",
"country_code": "US",
"telephone_number": "949-595-8610",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REGAN",
"first_name": "KEVIN",
"middle_name": "JACOB",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-12-21",
"last_updated": "2022-07-01",
"certification_date": "2022-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.