Individual provider Active NPI

Jill Louise Zatyko, LMFT

  • Marriage & Family Therapist
  • Lakeside, CA
National Provider Identifier
1164723789
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
111666 Issued in CA
Practice address
9049 Calle Lucia
Lakeside, CA 92040-5002
Phone
(619) 375-4666
Fax
(619) 369-4535
NPI assigned
Nov 12, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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 111666 CA Primary

Addresses

Primary practice location

9049 Calle Lucia
Lakeside, CA 92040-5002

Mailing address

9049 Calle Lucia
Lakeside, CA 92040-5002
Phone (619) 375-4666

Other practice location 1

2525 Camino Del Rio S Ste 310
San Diego, CA 92108-3784
Phone (619) 375-4666

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
I20250122001521 CA Practitioner - Marriage and Family Therapist 3678002573 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Mental Health CurrentSince Dec 17, 2024 Accepting new patients
Community Research Foundation Inc Past Accepting new patients
Community Research Foundation Inc Past Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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": "1289520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1164723789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9049 CALLE LUCIA",
            "city": "LAKESIDE",
            "state": "CA",
            "postal_code": "920405002",
            "telephone_number": "619-375-4666",
            "fax_number": "619-369-4535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9049 CALLE LUCIA",
            "city": "LAKESIDE",
            "state": "CA",
            "postal_code": "920405002",
            "telephone_number": "619-375-4666",
            "fax_number": "619-369-4535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 Camino Del Rio S Ste 310",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921083784",
            "country_code": "US",
            "telephone_number": "619-375-4666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZATYKO",
        "first_name": "JILL",
        "middle_name": "LOUISE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-12",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "111666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeside, CA

Sources for this page

Verify at the official NPI Registry.