Individual provider Active NPI

Chelsea Margaret Thouvenot, MD

  • Psychiatry Physician
  • San Diego, CA
National Provider Identifier
1083076129
Registry record updated Jul 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A173869 Issued in CA
Practice address
1250 6TH Ave Ste 100
San Diego, CA 92101-4368
Phone
(619) 515-2430
NPI assigned
Mar 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A173869 CA
Psychiatry Physician 2084P0800X A173869 CA Primary

Addresses

Primary practice location

1250 6TH Ave Ste 100
San Diego, CA 92101-4368

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 515-2300

Other practice location 1

2859 El Cajon Blvd Ste 200
San Diego, CA 92104-1292
Phone (866) 420-2524

Other names 1

  • Chelsea Margaret Thouvenot-Brakefield Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211227001225 CA Practitioner - Psychiatry 6800287954 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A173869CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Dec 17, 2021 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Dec 17, 2021 Accepting new patients

Locations

1250 6th Ave
Ste 100
San Diego, CA 92101
Phone (619) 515-2430

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689465600000",
    "number": "1083076129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 6TH AVE STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921014368",
            "telephone_number": "619-515-2430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2859 El Cajon Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921041292",
            "country_code": "US",
            "telephone_number": "866-420-2524",
            "fax_number": "760-230-1491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOUVENOT",
        "first_name": "CHELSEA",
        "middle_name": "MARGARET",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2023-07-16",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A173869",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A173869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHELSEA",
            "last_name": "THOUVENOT-BRAKEFIELD",
            "middle_name": "MARGARET",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.