Active NPI
Jessica Cozzetto-Duong, M.A.
- Marriage & Family Therapist
- San Luis Obispo, CA
National Provider Identifier
1235433996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 73094
- Practice address
- 2180 Johnson Ave
San Luis Obispo, CA 93401-4558 - Phone
- (805) 781-4290
- Fax
- (805) 781-4297
- NPI assigned
- Jan 10, 2011
- Last updated
- Apr 5, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 73094 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | CA |
Addresses
Primary practice location
2180 Johnson Ave
San Luis Obispo, CA 93401-4558
Mailing address
2180 Johnson Ave
San Luis Obispo, CA 93401-4558
Phone (805) 781-4290
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
| License | State | Type | Specialty |
|---|---|---|---|
| 73094 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491350400000",
"number": "1235433996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2180 JOHNSON AVE",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934014558",
"telephone_number": "805-781-4290",
"fax_number": "805-781-4297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2180 JOHNSON AVE",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934014558",
"telephone_number": "805-781-4290",
"fax_number": "805-781-4297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COZZETTO-DUONG",
"first_name": "JESSICA",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-10",
"last_updated": "2017-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "73094",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.