NPIMap

Organization Active NPI

Potentia Family Therapy, Inc.

Doing business as Potentia

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1225316391
Registry record updated Jul 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
44584 Issued in CA
Legal business name
POTENTIA FAMILY THERAPY, INC.
Doing business as
Potentia
Practice address
3160 Camino del Rio S
304
San Diego, CA 92108-3813
Phone
(619) 819-0283
Fax
(619) 819-0284
NPI assigned
Jul 23, 2011
Last updated
Jul 23, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2011

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

Authorized official

Name
Mrs. Rebecca D Bass-Ching, LMFT
Title
Owner and Director
Phone
(619) 819-0283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 44584 CA Primary

Addresses

Primary practice location

3160 Camino del Rio S
304
San Diego, CA 92108-3813

Mailing address

3160 Camino del Rio S
304
San Diego, CA 92108-3813
Phone (619) 819-0283

Other names 1

  • Potentia Doing business as

National Provider Directory

National Provider Directory

Locations

3160 Camino del Rio S
Ste 304
San Diego, CA 92108
Phone (619) 819-0283

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1311379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311379200000",
    "number": "1225316391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3160 CAMINO DEL RIO S",
            "address_2": "304",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083813",
            "telephone_number": "619-819-0283",
            "fax_number": "619-819-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3160 CAMINO DEL RIO S",
            "address_2": "304",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083813",
            "telephone_number": "619-819-0283",
            "fax_number": "619-819-0284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTENTIA FAMILY THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-23",
        "last_updated": "2011-07-23",
        "status": "A",
        "authorized_official_last_name": "BASS-CHING",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER AND DIRECTOR",
        "authorized_official_telephone_number": "619-819-0283",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "44584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Potentia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 23, 2011; 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.