Individual provider Active NPI

Pete McClintock, M.A., MFT

  • Mental Health Counselor
  • San Diego, CA
National Provider Identifier
1164524054
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MFC27356 Issued in CA
Practice address
3411 3Rd Ave
San Diego, CA 92103-4906
Phone
(619) 299-0975
Fax
(619) 291-6738
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MFC27356 CA Primary

Addresses

Primary practice location

3411 3Rd Ave
San Diego, CA 92103-4906

Mailing address

3411 3Rd Ave
San Diego, CA 92103-4906
Phone (619) 299-0975

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

LicenseStateTypeSpecialty
MFC27356CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164524054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 3RD AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034906",
            "telephone_number": "619-299-0975",
            "fax_number": "619-291-6738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 3RD AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034906",
            "telephone_number": "619-299-0975",
            "fax_number": "619-291-6738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLINTOCK",
        "first_name": "PETE",
        "name_prefix": "Mr.",
        "credential": "M.A., MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFC27356",
            "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 Jul 8, 2007; 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.