Jean Elizabeth Dudley, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

124413 Issued in CA

Practice address

6906 Miramar Rd Ste C-164
San Diego, CA 92121-2666

Phone

(281) 782-1359

NPI assigned

Jun 3, 2021

Last updated

Aug 20, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Jean Elizabeth Cook Former name

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Specialty

Marriage and Family Therapist

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cyti Health PC

  dba Cyti Psychological

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Diego, CA
  • NPI 1679172290
  Medicare reassignment NPD

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1114593738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6906 MIRAMAR RD STE C-164",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212666",
            "telephone_number": "281-782-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6906 MIRAMAR RD STE C-164",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212666",
            "telephone_number": "281-782-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "JEAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "124413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEAN",
            "last_name": "COOK",
            "middle_name": "ELIZABETH",
            "prefix": "MS.",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dallas Edward Dudelston
• Riya Dudhoria
• Mellie Bautista Dudkin
• Robert James Dudl, MD
• Celia L Dudley, LVN
• Katherine Marie Dudley, MD
• Michelle Dudzik, RN
• Ana D Duenas, MA, BCBA
• Cecilia Duenas, PSY
• Karenina Tanjoco Duenas, CADC-I

• Marriage & Family Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.