Individual provider Active NPI

Marilyn Sara Freeman, PH.D., MFT

  • Marriage & Family Therapist
  • La Jolla, CA
National Provider Identifier
1063739076
Registry record updated Apr 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC7750 Issued in CA
Practice address
9834 Genesee Ave
Ste. 427
La Jolla, CA 92037-1223
Phone
(858) 502-5553
Fax
(760) 436-0066
NPI assigned
Apr 29, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2010

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 MFC7750 CA Primary

Addresses

Primary practice location

9834 Genesee Ave
Ste. 427
La Jolla, CA 92037-1223

Mailing address

3301 Avenida Anacapa
Carlsbad, CA 92009-9324
Phone (760) 436-0066

Other identifiers 1

IdentifierTypeStateIssuer
106H00000XOtherCACA BOARD OF BEHAVIORAL SCIENCE

Other names 1

  • Dr. Marilyn Sara Freeman Former name

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MFC7750CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272499200000",
    "number": "1063739076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 AVENIDA ANACAPA",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920099324",
            "telephone_number": "760-436-0066",
            "fax_number": "760-436-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9834 GENESEE AVE",
            "address_2": "STE. 427",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371223",
            "telephone_number": "858-502-5553",
            "fax_number": "760-436-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "MARILYN",
        "middle_name": "SARA",
        "credential": "PH.D., MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-29",
        "last_updated": "2010-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC7750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA BOARD OF BEHAVIORAL SCIENCE",
            "identifier": "106H00000X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARILYN",
            "last_name": "FREEMAN",
            "middle_name": "SARA",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2010; 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.