Individual provider Active NPI

Gloria I Jardon, LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1003901992
Registry record updated Jan 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
51151 Issued in CA
Practice address
9820 Willow Creek Rd
Suite 245
San Diego, CA 92131-1112
Phone
(858) 212-4244
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 51151 CA Primary

Addresses

Primary practice location

9820 Willow Creek Rd
Suite 245
San Diego, CA 92131-1112

Mailing address

PO Box 712742
Santee, CA 92072-2742
Phone (858) 212-4244

Other identifiers 1

IdentifierTypeStateIssuer
9607OtherCA9607

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610150400000",
    "number": "1003901992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 712742",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920722742",
            "telephone_number": "858-212-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9820 WILLOW CREEK RD",
            "address_2": "SUITE 245",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311112",
            "telephone_number": "858-212-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARDON",
        "first_name": "GLORIA",
        "middle_name": "I",
        "name_prefix": "Miss",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2021-01-09",
        "certification_date": "2021-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "51151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "9607",
            "identifier": "9607",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.