Individual provider Active NPI

Jocelyn Marlen Granillo Gallegos

  • Marriage & Family Therapist
  • Roseville, CA
National Provider Identifier
1013626357
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
152634 Issued in CA
Practice address
2530 Douglas Blvd Ste 160
Roseville, CA 95661-3991
Phone
(916) 400-0505
NPI assigned
Nov 15, 2022
Last updated
May 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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 152634 CA Primary

Addresses

Primary practice location

2530 Douglas Blvd Ste 160
Roseville, CA 95661-3991

Mailing address

2530 Douglas Blvd Ste 160
Roseville, CA 95661-3991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250602003144 CA Practitioner - Marriage and Family Therapist 1658880505 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

330 Oxford St
Suite 208B
Chula Vista, CA 91911-3119
Phone (760) 278-3112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
152634CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Behavior Health & Wellness Center, LLC CurrentSince Apr 1, 2025 Accepting new patients
Calm Waters Counseling, LLC CurrentSince Apr 1, 2025 Accepting new patients

Locations

330 Oxford St
Ste 208A
Chula Vista, CA 91911
Phone (510) 776-3984

330 Oxford St
Ste 208B
Chula Vista, CA 91911
Phone (760) 278-3112

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1013626357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 DOUGLAS BLVD STE 160",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 DOUGLAS BLVD STE 160",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613991",
            "telephone_number": "916-400-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANILLO GALLEGOS",
        "first_name": "JOCELYN",
        "middle_name": "MARLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-15",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "152634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.