Active NPI
Alicia Lee Fong, LMFT
- Marriage & Family Therapist
- San Diego, CA
National Provider Identifier
1235877309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT122190
- Practice address
- 4366 Ohio St
San Diego, CA 92104-1318 - Phone
- (619) 914-6853
- NPI assigned
- May 26, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LMFT122190 | CA | Primary |
Addresses
Primary practice location
4366 Ohio St
San Diego, CA 92104-1318
Mailing address
4366 Ohio St
San Diego, CA 92104-1318
Phone (619) 914-6853
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMFT122190 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653523200000",
"number": "1235877309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4366 OHIO ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921041318",
"telephone_number": "619-914-6853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4366 OHIO ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921041318",
"telephone_number": "619-914-6853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE FONG",
"first_name": "ALICIA",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-26",
"last_updated": "2022-05-26",
"certification_date": "2022-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "LMFT122190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 May 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.