NPIMap

Organization Active NPI

Avita Family Therapy and Wellness Center, Inc.

  • Community/Behavioral Health Agency
  • San Diego, CA
National Provider Identifier
1225520885
Registry record updated Aug 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
AVITA FAMILY THERAPY AND WELLNESS CENTER, INC.
Doing business as
Avita Family Therapy
Avita Therapy
Avita Therapy Center3 more in Other names
Practice address
9666 Businesspark Ave Ste 207
San Diego, CA 92131
Phone
(858) 367-0525
Fax
(858) 367-8383
NPI assigned
May 30, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2018

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

Authorized official

Name
Sara Hirad, PSY.D.NPI 1912315052
Title
Director of Therapy Services
Phone
(858) 361-9228

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Community/Behavioral Health Agency 251S00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

9666 Businesspark Ave Ste 207
San Diego, CA 92131

Mailing address

PO Box 2498
Del Mar, CA 92014-1798
Phone (858) 361-9228

Other names 6

  • Avita Family Therapy Doing business as
  • Avita Therapy Doing business as
  • Avita Therapy Center Doing business as
  • Avita Therapy and Wellness Doing business as
  • Avita Wellness Doing business as
  • Avita Wellness Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535155200000",
    "number": "1225520885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2498",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920141798",
            "telephone_number": "858-361-9228",
            "fax_number": "858-367-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9666 BUSINESSPARK AVE STE 207",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92131",
            "telephone_number": "858-367-0525",
            "fax_number": "858-367-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVITA FAMILY THERAPY AND WELLNESS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-30",
        "last_updated": "2018-08-25",
        "status": "A",
        "authorized_official_last_name": "HIRAD",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "DIRECTOR OF THERAPY SERVICES",
        "authorized_official_telephone_number": "858-361-9228",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avita Family Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avita Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avita Therapy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avita Therapy and Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avita Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avita Wellness Center",
            "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 Aug 25, 2018; 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.