Jefferson Tucker Edmonds, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT36498 Issued in CA

Practice address

9620 Chesapeake Dr
Ste. 206
San Diego, CA 92123-1369

Phone

(619) 814-6590

Fax

(619) 814-6591

NPI assigned

Nov 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Psychiatric Centers at San Diego, Inc. Med GRP

  • Mental Health Counselor
  • San Diego, CA
  • NPI 1841241585

  Marriage & Family Therapist

  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1205900032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 609001",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921609001",
            "telephone_number": "619-528-4600",
            "fax_number": "619-528-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9620 CHESAPEAKE DR",
            "address_2": "STE. 206",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231369",
            "telephone_number": "619-814-6590",
            "fax_number": "619-814-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDS",
        "first_name": "JEFFERSON",
        "middle_name": "TUCKER",
        "name_prefix": "Mr.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT36498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Elizabeth Edlebeck
• Brandon Craig Edmond
• Estrellita Delrosar Edmond, I.D.C
• James Antonio Edmond
• Eric William Edmonds, MD
• Kyle Palmer Edmonds, M.D., FAAHPM
• Matthew James Carlos Edmondson
• Elizabeth Edmonston, RN
• Edmund W. Jay, D.D.S.,Inc.
• Benjamin Cal Edmunds, DDS

• 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 Dec 3, 2015; 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.