Individual provider Active NPI

Lisa Carolyn McJunkin, LMFT

  • Marriage & Family Therapist
  • Escondido, CA
National Provider Identifier
1215060991
Registry record updated Nov 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
50842 Issued in CA
Practice address
1602 Jose LN
Escondido, CA 92026-2051
Phone
(619) 987-0158
NPI assigned
Mar 13, 2007
Reactivated
Oct 31, 2023
Last updated
Nov 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2023

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 50842 CA Primary

Addresses

Primary practice location

1602 Jose LN
Escondido, CA 92026-2051

Mailing address

1602 Jose LN
Escondido, CA 92026-2051
Phone (619) 987-0158

Other names 1

  • Lisa Carolyn Maley Former name

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
I20240327002795 CA Practitioner - Marriage and Family Therapist 4789020744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Azam MD and McJunkin Prof CorpGroup PAC ID 7416393475, 2 clinicians

Practice addresses (Care Compare)

3455 Ingraham St
San Diego, CA 92109-6713
Phone (619) 937-2055

431 W Grand Ave
Suite 202
Escondido, CA 92025-2607
Phone (619) 937-2055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Azam MD & McJunkin Prof Corp Marriage & Family Therapist CurrentSince Jan 14, 2024 Accepting new patients
Azam MD PC Marriage & Family Therapist CurrentSince Sep 24, 2023 Accepting new patients

Locations

431 W Grand Ave
Ste 202
Escondido, CA 92025
Phone (619) 937-2055

3455 Ingraham St
San Diego, CA 92109
Phone (442) 777-2040

9845 Erma Rd
Ste 200
San Diego, CA 92131
Phone (616) 402-3028

Interoperability endpoints

  • Direct secure messaging: daydreammdintegrativehw.lisamcjunkin@158311.advancedmd-direct.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700265600000",
    "number": "1215060991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 JOSE LN",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920262051",
            "telephone_number": "619-987-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 JOSE LN",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920262051",
            "telephone_number": "619-987-0158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCJUNKIN",
        "first_name": "LISA",
        "middle_name": "CAROLYN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2023-11-18",
        "certification_date": "2023-11-18",
        "deactivation_date": "2023-09-21",
        "reactivation_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "50842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "MALEY",
            "middle_name": "CAROLYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.