Individual provider Active NPI

Reena Mittal, LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1194152694
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 52776 Issued in CA
Practice address
12625 High Bluff Dr Ste 104
San Diego, CA 92130-2053
Phone
(858) 925-3855
NPI assigned
Sep 30, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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 MFC 52776 CA Primary

Addresses

Primary practice location

12625 High Bluff Dr Ste 104
San Diego, CA 92130-2053

Mailing address

12625 High Bluff Dr Ste 104
San Diego, CA 92130-2053
Phone (858) 925-3855

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

State licenses

LicenseStateTypeSpecialty
MFC 52776CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Reena Mittal Individual and Family Therapy Services Inc Marriage & Family Therapist Current Accepting new patients

Locations

12625 High Bluff Dr
Ste 104
San Diego, CA 92130
Phone (858) 208-9689

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": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1194152694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12625 HIGH BLUFF DR STE 104",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302053",
            "telephone_number": "858-925-3855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12625 HIGH BLUFF DR STE 104",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302053",
            "telephone_number": "858-925-3855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTAL",
        "first_name": "REENA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-30",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 52776",
            "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 Sep 30, 2013; 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.