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NPI Code Detail

MEDICARE: MISA BUTSUHARA LMFT

MEDICARE: MISA BUTSUHARA LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistMFC 52096CA

General Provider Information

NPI Number : 1063761526
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISA BUTSUHARA LMFT
Provider Business Mailing Address
First Line : P.O. BOX 9543
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92658
Country : US
Telephone Number : 949-306-9913
Fax Number :
Provider Business Practice Location Address
First Line : 4667 MACARTHUR BLVD.
Second Line : SUITE 320
City : NEWPORT BEACH
State : CA
Zip : 92660
Country : US
Telephone Number : 949-306-9913
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2012
Last Update Date : 04/27/2026

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