THERESA BLACK


Address: 2011 S El Camino Real, San Clemente, CA 92672-3277
Phone: 9493424070

THERESA BLACK (NPI# 1992289607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 106H00000X Marriage & Family Therapist 108675 CA Behavioral Health & Social Service Providers

Other Providers THERESA BLACK

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

Office Location

Street Address 2011 S EL CAMINO REAL
City SAN CLEMENTE
State CA
Zip Code 92672-3277

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 106H00000X
Grouping Behavioral Health & Social Service Providers
Classification Marriage & Family Therapist

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Competitor

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City SAN CLEMENTE
Zip Code 92672

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Dataset Information

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.

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