Individual provider Active NPI

Floyd Henry Sellers

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1053897371
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT21847 Issued in CA
Practice address
10640 Scripps Ranch Blvd Ste 200
San Diego, CA 92131-1095
Phone
(760) 529-6859
Fax
(760) 529-6859
NPI assigned
Jul 19, 2018
Last updated
Jul 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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 LMFT21847 CA Primary

Addresses

Primary practice location

10640 Scripps Ranch Blvd Ste 200
San Diego, CA 92131-1095

Mailing address

5336 Maryland Ave
La Mesa, CA 91942-1514
Phone (619) 462-8917

Other identifiers 2

IdentifierTypeStateIssuer
CAQH14274726OtherPROVIEW SYSTEMS
CAQH14274726MedicaidCA

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
LMFT21847CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1053897371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5336 MARYLAND AVE",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919421514",
            "telephone_number": "619-462-8917",
            "fax_number": "619-462-8917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10640 SCRIPPS RANCH BLVD STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311095",
            "telephone_number": "760-529-6859",
            "fax_number": "760-529-6859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLERS",
        "first_name": "FLOYD",
        "middle_name": "HENRY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-19",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT21847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIEW SYSTEMS",
            "identifier": "CAQH14274726",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CAQH14274726",
            "state": "CA"
        }
    ],
    "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 19, 2018; 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.