Individual provider Active NPI

Richard Logan Shurtz, LMFT

  • Marriage & Family Therapist
  • Thousand Oaks, CA
National Provider Identifier
1972341741
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
29278 Issued in CA
Practice address
25 Rolling Oaks Dr Ste 204
Thousand Oaks, CA 91361-1009
Phone
(805) 285-3193
NPI assigned
Jul 17, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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 29278 CA Primary

Addresses

Primary practice location

25 Rolling Oaks Dr Ste 204
Thousand Oaks, CA 91361-1009

Mailing address

25 Rolling Oaks Dr Ste 204
Thousand Oaks, CA 91361-1009
Phone (805) 285-3193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Sep 4, 2024 through Sep 4, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
29278CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1721174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1972341741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 ROLLING OAKS DR STE 204",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611009",
            "telephone_number": "805-285-3193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 ROLLING OAKS DR STE 204",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611009",
            "telephone_number": "805-285-3193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHURTZ",
        "first_name": "RICHARD",
        "middle_name": "LOGAN",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-17",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "29278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.