Individual provider Active NPI

Shelby Michele Alane Espiritu, LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1053924993
Registry record updated Aug 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
114109 Issued in CA
Practice address
9655 Granite Ridge Dr
San Diego, CA 92123-2674
Phone
(858) 413-7746
NPI assigned
Aug 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2020

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 114109 CA Primary

Addresses

Primary practice location

9655 Granite Ridge Dr
San Diego, CA 92123-2674

Mailing address

PO Box 28294
San Diego, CA 92198-0294
Phone (858) 413-7746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
114109CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1598659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598659200000",
    "number": "1053924993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28294",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921980294",
            "telephone_number": "858-413-7746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9655 GRANITE RIDGE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232674",
            "telephone_number": "858-413-7746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPIRITU",
        "first_name": "SHELBY",
        "middle_name": "MICHELE ALANE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-29",
        "last_updated": "2020-08-29",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "114109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.