Active NPI
Shelley Davidescu, M.A. IMF
- Marriage & Family Therapist
- El Cajon, CA
National Provider Identifier
1154636884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 900 N Cuyamaca St
Suite 110
El Cajon, CA 92020-1809 - Phone
- (619) 448-0420
- NPI assigned
- Aug 18, 2010
- Last updated
- Sep 3, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 63694 | CA | |
| Marriage & Family Therapist | 106H00000X | Primary |
Addresses
Primary practice location
900 N Cuyamaca St
Suite 110
El Cajon, CA 92020-1809
Mailing address
900 N Cuyamaca St
Suite 110
El Cajon, CA 92020-1809
Phone (619) 448-0420
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63694 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Research Foundation Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Step Forward East
- Community/Behavioral Health Agency
- El Cajon, CA
- NPI 1558885442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409702400000",
"number": "1154636884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 N CUYAMACA ST",
"address_2": "SUITE 110",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920201809",
"telephone_number": "619-448-0420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 N CUYAMACA ST",
"address_2": "SUITE 110",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920201809",
"telephone_number": "619-448-0420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDESCU",
"first_name": "SHELLEY",
"credential": "M.A. IMF",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-18",
"last_updated": "2014-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "63694",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Cajon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.