Individual provider Active NPI

Yamilka Urquiza Mendoza, PSYD IN MFT

  • Family Psychologist
  • San Diego, CA
National Provider Identifier
1033657234
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family PsychologistTaxonomy code 103TF0000X
License
LMFT112227 Issued in CA
Practice address
10065 Old Grove Rd Ste 102
San Diego, CA 92131-1664
Phone
(239) 877-2039
NPI assigned
Feb 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 112227 CA
Mental Health Counselor 101YM0800X IMF95606 CA
Student in an Organized Health Care Education/Training Program 390200000X IMF95606 CA
Family Psychologist 103TF0000X LMFT112227 CA Primary

Addresses

Primary practice location

10065 Old Grove Rd Ste 102
San Diego, CA 92131-1664

Mailing address

10065 Old Grove Rd Ste 102
San Diego, CA 92131-1664
Phone (239) 877-2039

Other practice location 1

1161 Bay Blvd
Suite B
Chula Vista, CA 91911-2670
Phone (619) 585-7686

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
LMFT112227CAMDFamily Psychologist
112227CAMDMarriage & Family Therapist
IMF95606CAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Halcyon Family Health, Inc. CurrentSince Aug 28, 2021 Accepting new patients
Community Research Foundation Past Accepting new patients

Locations

10065 Old Grove Rd
Ste 102
San Diego, CA 92131
Phone (619) 387-8386

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1033657234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10065 OLD GROVE RD STE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311664",
            "telephone_number": "239-877-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10065 OLD GROVE RD STE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311664",
            "telephone_number": "239-877-2039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1161 Bay Blvd",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Chula Vista",
            "state": "CA",
            "postal_code": "919112670",
            "country_code": "US",
            "telephone_number": "619-585-7686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "URQUIZA MENDOZA",
        "first_name": "YAMILKA",
        "name_prefix": "Dr.",
        "credential": "PSYD IN MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-08",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "112227",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "IMF95606",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "IMF95606",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "CA",
            "license": "LMFT112227",
            "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 Mar 10, 2020; 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.