Individual provider Active NPI

Leslie Karen Fadem, MA

  • Marriage & Family Therapist
  • La Mesa, CA
National Provider Identifier
1194932178
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC27790 Issued in CA
Practice address
7284 Princeton Ave
La Mesa, CA 91941-4716
Phone
(619) 698-6605
Fax
(619) 698-6605
NPI assigned
May 17, 2007
Sex
Female
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
Marriage & Family Therapist 106H00000X MFC27790 CA Primary

Addresses

Primary practice location

7284 Princeton Ave
La Mesa, CA 91941-4716

Mailing address

PO Box 3191
La Mesa, CA 91944-3191
Phone (760) 632-1670

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
MFC27790CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194932178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3191",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919443191",
            "telephone_number": "760-632-1670",
            "fax_number": "619-698-6605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7284 PRINCETON AVE",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919414716",
            "telephone_number": "619-698-6605",
            "fax_number": "619-698-6605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADEM",
        "first_name": "LESLIE",
        "middle_name": "KAREN",
        "name_prefix": "Ms.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC27790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, 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.