Organization Active NPI

MMG Licensed Marriage and Family Therapy

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1083513725
Registry record updated Oct 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
MMG LICENSED MARRIAGE AND FAMILY THERAPY
Practice address
4660 El Cajon Blvd Ste 205
San Diego, CA 92115-4468
Phone
(619) 734-7143
Fax
(619) 340-1126
NPI assigned
Oct 31, 2026
Last updated
Oct 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2026

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

Authorized official

Name
Melissa Monique Guaderrama
Title
Owner
Phone
(619) 306-4321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

4660 El Cajon Blvd Ste 205
San Diego, CA 92115-4468

Mailing address

1379 Stanislaus Dr
Chula Vista, CA 91913-1403
Phone (617) 734-7143

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1793404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793404800000",
    "number": "1083513725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1379 STANISLAUS DR",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919131403",
            "telephone_number": "617-734-7143",
            "fax_number": "619-340-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 EL CAJON BLVD STE 205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154468",
            "telephone_number": "619-734-7143",
            "fax_number": "619-340-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMG LICENSED MARRIAGE AND FAMILY THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-31",
        "last_updated": "2026-10-31",
        "certification_date": "2026-10-31",
        "status": "A",
        "authorized_official_last_name": "GUADERRAMA",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "MONIQUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-306-4321"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 31, 2026; 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.