Individual provider Active NPI

Letty Guadalupe Campa

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1013545334
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
147337 Issued in CA
Practice address
1424 30TH St Ste a
San Diego, CA 92154-3417
Phone
(619) 565-2650
Fax
(619) 565-2656
NPI assigned
Mar 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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 147337 CA Primary

Addresses

Primary practice location

1424 30TH St Ste a
San Diego, CA 92154-3417

Mailing address

1424 30TH St Ste a
San Diego, CA 92154-3417
Phone (619) 565-2650

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

State licenses

LicenseStateTypeSpecialty
147337CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Episcopal Community Services CurrentSince Aug 25, 2024 Accepting new patients
Community Research Foundation Inc PastSince Apr 1, 2020 Accepting new patients
Episcopal Community Services PastSince Aug 25, 2024 Accepting new patients

Locations

1424 30th St
Ste A
San Diego, CA 92154
Phone (619) 248-1570

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1013545334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 30TH ST STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921543417",
            "telephone_number": "619-565-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 30TH ST STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921543417",
            "telephone_number": "619-565-2650",
            "fax_number": "619-565-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPA",
        "first_name": "LETTY",
        "middle_name": "GUADALUPE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "147337",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 21, 2024; 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.