MR. JEFFREY RANDALL WIRTH (NPI# 1447424031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447424031 |
| Entity Type | Individual |
| Full Name | MR. JEFFREY RANDALL WIRTH |
| Credential | MFT |
| Practice Address |
8485 Tamarind Ave, Ca Fontana CA 92335-3975 |
| Mailing Address |
6194 Olive Ave San Bernardino CA 92407-2167 |
| Practice Telephone | 9092773189 |
| Mailing Telephone | 9098042355 |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2013-12-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
MFC30166 | CA | Behavioral Health & Social Service Providers |
| Y | 106H00000X | Marriage & Family Therapist | MFC30166 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508163361 | Jeffrey Michael Wirth | Counselor | 325 S University Rd, Suite 202, Spokane Valley, WA 99206-6164 | 2011-02-14 |
| Street Address |
8485 TAMARIND AVE , CA |
| City | FONTANA |
| State | CA |
| Zip Code | 92335-3975 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104425131 | Hossein Malakooti A Dental Corporation | Clinic/Center | 16540 Merrill Ave, Fontana, CA 92335 | 2020-10-21 |
| 1790312791 | Trevor Nguyen | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd, Building A, Fontana, CA 92335 | 2020-03-27 |
| 1184251365 | Benjamin Chang | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd., Bldg. A, Fontana, CA 92335 | 2020-03-26 |
| 1407487309 | Perla Hernandez | Licensed Vocational Nurse | 14677 Merrill Aver, Fontana, CA 92335 | 2020-01-29 |
| 1013552660 | Valencia Malone | Licensed Vocational Nurse | 14677 Merrill, Fontana, CA 92335 | 2019-11-07 |
| 1831749779 | Daniel Eric Wright | Student in an Organized Health Care Education/Training Program | 14677 Merrell Ave., Fontana, CA 92335 | 2019-09-12 |
| 1962069815 | Melissa Rivera | Licensed Vocational Nurse | 15217 San Bernardino Ave., Fontana, CA 92335 | 2019-05-28 |
| 1275199770 | Jennifer Lynn Malone | Peer Specialist | 14677 Merrall Ave, Fontana, CA 92335 | 2019-05-10 |
| 1770147894 | Noelle Chong | Registered Nurse | 14677 Merill Ave, Fontana, CA 92335 | 2019-04-24 |
| 1992261929 | Destiny Alzate | Counselor | 1467 Merrill Ave, Fontana, CA 92335 | 2019-02-14 |
| Find all providers in zip 92335 | ||||
| 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 |
|---|---|---|---|---|
| 1639779861 | Marissa Lehto | Marriage & Family Therapist | 6135 La Costa, Fontana, CA 92336-5683 | 2020-10-27 |
| 1407474349 | Nancy Louise Felix | Marriage & Family Therapist | 16001 Chase Rd Unit 50, Fontana, CA 92336-5083 | 2020-07-07 |
| 1396213567 | Summer Dowd-lukesh | Marriage & Family Therapist | 17057 Foothill Blvd, Fontana, CA 92335-3574 | 2018-11-06 |
| 1568961183 | Jordan Frailey | Marriage & Family Therapist | 9161 Sierra Ave. Suite 213, Fontana, CA 92336 | 2018-02-09 |
| 1205360575 | Pamela Burney | Marriage & Family Therapist | 15213 Willow Wood Ln, Fontana, CA 92336-0786 | 2017-04-13 |
| 1275065393 | Alyssa Calderon | Marriage & Family Therapist | 14335 Quail Ct, Fontana, CA 92336 | 2017-03-29 |
| 1992158307 | Crystalina Alvarez | Marriage & Family Therapist | 17210 Slover Ave, Fontana, CA 92337 | 2016-07-20 |
| 1801271499 | Maria De Jesus Nunez-flores | Marriage & Family Therapist | 16823 Arrow Blvd, Fontana, CA 92335-3803 | 2015-07-23 |
| 1003210899 | Cornerstone Counseling | Marriage & Family Therapist | 15292 Duncan Canyon Rd, Fontana, CA 92336-1210 | 2014-10-22 |
| 1295151363 | Mccall Stephens | Marriage & Family Therapist | 15511 Colt Ave, Fontana, CA 92337 | 2014-03-12 |
| Find all providers in FONTANA | ||||
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| 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.