Individual provider Active NPI

Teresa L Blenggio Martinez, MFT

  • Marriage & Family Therapist
  • Encinitas, CA
National Provider Identifier
1063768778
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
101015 Issued in CA
Practice address
1130 2ND St
Encinitas, CA 92024-5008
Phone
(760) 736-6767
NPI assigned
Jul 31, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

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 101015 CA Primary

Addresses

Primary practice location

1130 2ND St
Encinitas, CA 92024-5008

Mailing address

1130 2ND St
Encinitas, CA 92024-5008
Phone (760) 736-6767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, ID2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250718001034 CA Practitioner - Marriage and Family Therapist 6204342116 Reassigns benefits to 1 organization
I20260121001968 ID Practitioner - Marriage and Family Therapist 6204342116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101015CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Marriage & Family Therapist CurrentSince Dec 9, 2025 Accepting new patients
Grow Healthcare Group PC Marriage & Family Therapist CurrentSince Jun 4, 2025 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

950 W Bannock St
Ste 1100
Boise, ID 83702
Phone (201) 293-7689

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1063768778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 2ND ST",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245008",
            "telephone_number": "760-736-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 2ND ST",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245008",
            "telephone_number": "760-736-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLENGGIO MARTINEZ",
        "first_name": "TERESA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-31",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "101015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.