Enrique A Campo

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

114768 Issued in CA

Practice address

5000 Birch Street, West Tower
Suite 306
Newport Beach, CA 92660

Phone

(949) 891-2760

Fax

(888) 280-6765

NPI assigned

Mar 28, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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.

• Ace Individual and Family Therapy

  • Marriage & Family Therapist
  • Newport Beach, CA
  • NPI 1336774470
  NPD Authorized official
• Allyson Wells MD Inc

  • Child & Adolescent Psychiatry Physician
  • Long Beach, CA
  • NPI 1770181257
  NPD (past)
• Childnet Youth and Family Services Inc

  dba ChildNet Youth & Family Services Inc.

  • Community/Behavioral Health Agency
  • Long Beach, CA
  • NPI 1760519219
  NPD (past)

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1962934257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11253",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927111253",
            "telephone_number": "949-891-2760",
            "fax_number": "888-280-6765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 BIRCH STREET, WEST TOWER",
            "address_2": "SUITE 306",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92660",
            "telephone_number": "949-891-2760",
            "fax_number": "888-280-6765"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5150 E Pacific Coast Hwy",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908043312",
            "country_code": "US",
            "telephone_number": "562-490-7600",
            "fax_number": "562-490-7601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPO",
        "first_name": "ENRIQUE",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-28",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF98305",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "114768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "114768",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "(888)280-6765",
            "affiliation": "N",
            "address_1": "5000 Birch Street, West Tower",
            "address_2": "Suite 306",
            "city": "Newport Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "92660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Coleen Camiling
• Caroline Campama Piscotty, MA
• Bruce Thomas Campbell, DDS
• Byron Campbell, D.C.
• Karla Elizabete Campbell, MS, RD, CSSD
• Maria Angelica Campos de Ponce, MSC/MFCT, LMFT
• Alejandro Campos Fernandez
• Erica Campos Rogers, CATC 197173 I
• Biridiana Yunuen Campos
• Canaan Health Care, Inc.

• Marriage & Family Therapist in Newport Beach, CA
• Providers in Newport Beach, 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 Nov 9, 2020; 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.