Individual provider Active NPI

Brenda Lissett Duarte, LMFT

  • Marriage & Family Therapist
  • Chula Vista, CA
National Provider Identifier
1164784906
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
108090 Issued in CA
Practice address
2300 Boswell Rd Ste 275
Chula Vista, CA 91914-3557
Phone
(858) 279-1223
NPI assigned
Jun 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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 108090 CA Primary

Addresses

Primary practice location

2300 Boswell Rd Ste 275
Chula Vista, CA 91914-3557

Mailing address

2300 Boswell Rd Ste 275
Chula Vista, CA 91914-3557

Other practice location 1

9465 Farnham St
San Diego, CA 92123-1308
Phone (858) 573-2955

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
I20240603003047 CA Practitioner - Marriage and Family Therapist 1951843135 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
108090CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc CurrentSince Apr 21, 2024 Accepting new patients

Locations

2300 Boswell Rd
Ste 275
Chula Vista, CA 91914
Phone (585) 898-0612

8989 Rio San Diego Dr
Ste 200
San Diego, CA 92108
Phone (858) 357-5375

4550 Kearny Villa Rd
Ste 116
San Diego, CA 92123
Phone (619) 279-1223

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1164784906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 BOSWELL RD STE 275",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 BOSWELL RD STE 275",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143557",
            "telephone_number": "858-279-1223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9465 Farnham St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921231308",
            "country_code": "US",
            "telephone_number": "858-573-2955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUARTE",
        "first_name": "BRENDA",
        "middle_name": "LISSETT",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "108090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.