Individual provider Active NPI

Fernanda Michelle Mayorga, LMFT

  • Marriage & Family Therapist
  • Vallejo, CA
National Provider Identifier
1992416143
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT149157 Issued in CA
Practice address
1018 Gateway Dr
Vallejo, CA 94589-2092
Phone
(415) 260-6539
NPI assigned
Dec 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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 LMFT149157 CA Primary

Addresses

Primary practice location

1018 Gateway Dr
Vallejo, CA 94589-2092

Mailing address

1018 Gateway Dr
Vallejo, CA 94589-2092
Phone (415) 260-6539

Other practice location 1

24520 Hawthorne Blvd Ste 208
Torrance, CA 90505-6843
Phone (562) 584-7715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241003002350 CA Practitioner - Marriage and Family Therapist 3971034745 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT149157CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Therapeutic Alliance, a Licensed Clinical Social Worker Co CurrentSince Sep 25, 2024 Accepting new patients
Dynamic Psychotherapy Center Inc CurrentSince Jun 1, 2024 Accepting new patients
My Concierge Psychotherapy Inc CurrentSince Jun 1, 2024 Accepting new patients

Locations

24520 Hawthorne Blvd
Ste 208
Torrance, CA 90505
Phone (310) 738-1603

14500 Roscoe Blvd
Ste 400
Van Nuys, CA 91402
Phone (818) 741-2906

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1670457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1992416143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 GATEWAY DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892092",
            "telephone_number": "415-260-6539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 GATEWAY DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892092",
            "telephone_number": "415-260-6539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24520 Hawthorne Blvd Ste 208",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905056843",
            "country_code": "US",
            "telephone_number": "562-584-7715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYORGA",
        "first_name": "FERNANDA",
        "middle_name": "MICHELLE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-08",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT149157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.