THERESA BLACK (NPI# 1992289607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992289607 |
| Entity Type | Individual |
| Full Name | THERESA BLACK |
| Credential | MA |
| Practice Address |
2011 S El Camino Real San Clemente CA 92672-3277 |
| Mailing Address |
Po Box 1004 San Juan Capistrano CA 92693-1004 |
| Practice Telephone | 9493424070 |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2018-09-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 108675 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376802397 | Theresa L Black | Counselor | 333 Irving Ave, Capc First Floor, Bridgeton, NJ 08302-2123 | 2012-05-11 |
| 1568694248 | Theresa Joy Black | Social Worker | 1592 Granville Pike, Lancaster, OH 43130-1076 | 2009-08-14 |
| Street Address |
2011 S EL CAMINO REAL |
| City | SAN CLEMENTE |
| State | CA |
| Zip Code | 92672-3277 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265850804 | Deborah Phillips | Marriage & Family Therapist | 2011 S El Camino Real, Suite C, San Clemente, CA 92672-3277 | 2014-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355234 | Julie Case | Massage Therapist | 205 Via Presa, I Do Not Work From Home- I Am A Contractor, San Clemente, CA 92672 | 2020-10-30 |
| 1396213971 | Kirtney So Lim | Military Health Care Provider | 62 Area San Mateo Naval Clinic, Camp Pendleton, CA 92672 | 2018-11-13 |
| 1407322258 | Lodie Ikeda | Non-emergency Medical Transport (VAN) | 119 Avenida Dolores B, San Clemente, CA 92672 | 2018-10-19 |
| 1629566245 | I-ting Wang | Counselor | 3551 Camino Mira Costa San Clemente, Suite T, San Clemente, CA 92672 | 2018-04-30 |
| 1174046874 | Russell Thompson Chiropractic Inc | Clinic/Center | 629 Camino De Los Mares, Ste. 104, San Clemente, CA 92672 | 2017-07-25 |
| 1518320415 | Addiction Health Alliance LLC | Clinical Medical Laboratory | 605 Avenida Las Flores, San Clemente, CA 92672 | 2016-03-30 |
| 1871961342 | Paul Van Zeumeren | Marriage & Family Therapist | 2715 Calle Del Comercio, Unit C, San Clemente, CA 92672 | 2015-09-14 |
| 1194043596 | Sima Moayed | Pharmacist | 801 N. Elcamino Real, San Clemente, CA 92672 | 2010-05-10 |
| 1942539432 | Martha Elena Hall | Acupuncturist | 131 W. El Portal, San Clemente, CA 92672 | 2009-12-14 |
| 1922334515 | Katie B Mann | Social Worker | 1401 N. El Camino Real, #100, San Clemente, CA 92672 | 2009-11-02 |
| Find all providers in zip 92672 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609476332 | Nicolette Gubicza | Marriage & Family Therapist | 60 Via Cartama, San Clemente, CA 92673-6998 | 2020-10-30 |
| 1841897725 | Wade Justin Denes | Marriage & Family Therapist | 1302 S El Camino Real # A-3, San Clemente, CA 92672-4290 | 2020-10-05 |
| 1396201083 | Danielle Nicole Portney | Marriage & Family Therapist | 647 Camino De Los Mares Ste 201, San Clemente, CA 92673-2807 | 2019-02-18 |
| 1063977593 | Morgan Taylor Osgood | Marriage & Family Therapist | 616 S El Camino Real Ste G8, San Clemente, CA 92672-4297 | 2019-02-08 |
| 1982120200 | Emmanuel Romero | Marriage & Family Therapist | 333 Calle Escuela, San Clemente, CA 92672-2108 | 2017-08-17 |
| 1932648409 | Debra J. Lee-moreno | Marriage & Family Therapist | 1108 Las Posas, San Clemente, CA 92673-4006 | 2017-02-17 |
| 1275983462 | Lisa Gaskin | Marriage & Family Therapist | 208 W Avenida Gaviota, San Clemente, CA 92672-5442 | 2016-06-17 |
| 1871961342 | Paul Van Zeumeren | Marriage & Family Therapist | 2715 Calle Del Comercio, Unit C, San Clemente, CA 92672 | 2015-09-14 |
| 1801278403 | Rima Danielle Jomaa | Marriage & Family Therapist | 229 Avenida Victoria, Apt 2, San Clemente, CA 92672-1917 | 2015-06-19 |
| 1427454636 | Marc Rosenberg | Marriage & Family Therapist | 3030 Calle Frontera, San Clemente, CA 92673-3009 | 2014-11-15 |
| Find all providers in SAN CLEMENTE | ||||
| City | SAN CLEMENTE |
| Zip Code | 92672 |
Please comment or provide details below to improve the information on THERESA BLACK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.