Lisa Anne Bertelle, M.S., MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC 40984 Issued in CA

Practice address

1031 25TH St
San Diego, CA 92102-2194

Phone

(619) 232-6454

NPI assigned

Nov 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1164596300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 25TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921022194",
            "telephone_number": "619-232-6454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 25TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921022194",
            "telephone_number": "619-232-6454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTELLE",
        "first_name": "LISA",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "M.S., MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "40984",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 40984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Robert Berry, MD
• Zoe Berry, MSW
• Linda Bertha Berryman, LVN
• Melissa Bersamina, O.D.
• Francesca Maria Berta
• Bertha Gee-Lew MD Faap Inc
• Lisa Berthoud
• Teresa Renee Bertino, NP
• Bruno Bertone
• Kaitlyn Bertrand

• 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 Jan 30, 2023; 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.