Active NPI
MMG Licensed Marriage and Family Therapy
- Marriage & Family Therapist
- San Diego, CA
National Provider Identifier
1083513725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- 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, 2026
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 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 DirectoryNPI 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.