Individual provider Active NPI

Michelle Malott, MA

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1154819894
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
120215 Issued in CA
Practice address
6949 Hyde Park Dr
San Diego, CA 92119-2208
Phone
(510) 493-0132
NPI assigned
Apr 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 120215 CA Primary

Addresses

Primary practice location

6949 Hyde Park Dr
San Diego, CA 92119-2208

Mailing address

6949 Hyde Park Dr
San Diego, CA 92119-2208

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240515003872 CA Practitioner - Marriage and Family Therapist 0941641377 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cyti Health PCGroup PAC ID 4587012950, 34 clinicians

Practice addresses (Care Compare)

11801 Pierce St
Riverside, CA 92505-4408
Phone (866) 478-3978

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
120215CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cyti Health PC CurrentSince Aug 17, 2024 Accepting new patients
Center for New Directions, Inc. Mental Health CurrentSince Mar 19, 2024 Accepting new patients
Stephen M Pumphrey Licensed Clinical Social Workers Inc PastSince Dec 25, 2018 Accepting new patients

Locations

1101 California Ave
Ste 204
Corona, CA 92881
Phone (951) 523-0221

23201 Mill Creek Dr
Ste 220
Laguna Hills, CA 92653
Phone (949) 460-5320

11801 Pierce St
Riverside, CA 92505
Phone (909) 528-0317

402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939

3111 Camino del Rio N
Ste 460
San Diego, CA 92108

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": "1524787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1154819894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6949 HYDE PARK DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921192208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6949 HYDE PARK DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921192208",
            "telephone_number": "510-493-0132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALOTT",
        "first_name": "MICHELLE",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-27",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "120215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.