Individual provider Active NPI

Michael P Blanchard, MA, MFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1023285434
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT 77156 Issued in CA
Practice address
3555 Kenyon St Ste 101
San Diego, CA 92110-5341
Phone
(619) 600-0683
NPI assigned
May 14, 2008
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 LMFT 77156 CA Primary

Addresses

Primary practice location

3555 Kenyon St Ste 101
San Diego, CA 92110-5341

Mailing address

3555 Kenyon St Ste 101
San Diego, CA 92110-5341
Phone (619) 600-0683

Other practice location 1

3605 Vista Way
Suite 258
Oceanside, CA 92056-4565
Phone (760) 758-1480 ext. 7663

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LMFT 77156CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Family Guidance & Therapy Center of Southern California Marriage & Family Therapist CurrentSince Jul 24, 2022 Accepting new patients

Locations

3555 Kenyon St
Ste 101
San Diego, CA 92110
Phone (619) 600-0683

Organizations & group practices 1

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": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1023285434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 KENYON ST STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105341",
            "telephone_number": "619-600-0683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 KENYON ST STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105341",
            "telephone_number": "619-600-0683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3605 Vista Way",
            "address_2": "Suite 258",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "CA",
            "postal_code": "920564565",
            "country_code": "US",
            "telephone_number": "760-758-1480 x7663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANCHARD",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "credential": "MA, MFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT 77156",
            "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 Jul 21, 2022; 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.