=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366271561
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CARTER JOHN-THOMAS HASBROOK LMFT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/29/2024
-----------------------------------------------------
Last Update Date | 11/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 30950 RANCHO VIEJO RD STE 175
-----------------------------------------------------
City | SAN JUAN CAPISTRANO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92675-1772
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-940-6203
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 30950 RANCHO VIEJO RD STE 175
-----------------------------------------------------
City | SAN JUAN CAPISTRANO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92675-1772
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-940-6203
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 159112
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------