Active NPI
Mona Shizu Bourget, M.A.
- Marriage & Family Therapist
- El Cajon, CA
National Provider Identifier
1043353113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMF 53156
- Practice address
- 1679 E Main St
Suite 102
El Cajon, CA 92021-5212 - Phone
- (619) 441-1907
- Fax
- (619) 441-1908
- NPI assigned
- Feb 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF 53156 | CA | Primary |
Addresses
Primary practice location
1679 E Main St
Suite 102
El Cajon, CA 92021-5212
Mailing address
1679 East Main Street
Suite 102
El Cajon, CA 92021
Phone (619) 441-1907
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
| License | State | Type | Specialty |
|---|---|---|---|
| IMF 53156 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300752000000",
"number": "1043353113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1679 EAST MAIN STREET",
"address_2": "SUITE 102",
"city": "EL CAJON",
"state": "CA",
"postal_code": "92021",
"telephone_number": "619-441-1907",
"fax_number": "619-441-1908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1679 E MAIN ST",
"address_2": "SUITE 102",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920215212",
"telephone_number": "619-441-1907",
"fax_number": "619-441-1908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURGET",
"first_name": "MONA",
"middle_name": "SHIZU",
"name_prefix": "Mrs.",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-15",
"last_updated": "2011-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF 53156",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Cajon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.