Active NPI
Nancy Acevedo
- Marriage & Family Therapist
- San Diego, CA
National Provider Identifier
1255700514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 117819
- Practice address
- 1202 Morena Blvd Ste 300
San Diego, CA 92110-3844 - Phone
- (619) 276-8112
- NPI assigned
- Sep 16, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 117819 | CA | Primary |
Addresses
Primary practice location
1202 Morena Blvd Ste 300
San Diego, CA 92110-3844
Mailing address
1202 Morena Blvd Ste 300
San Diego, CA 92110-3844
Phone (619) 276-8112
Other practice location 1
637 3rd Ave Ste I
Chula Vista, CA 91910-5707
Phone (818) 618-1100
Other practice location 2
3002 Armstrong St
San Diego, CA 92111
Phone (858) 277-9550
Other practice location 3
3002 Armstrong St
San Diego, CA 92111
Phone (858) 277-9550
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 17, 2024 through Dec 17, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 117819 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627862400000",
"number": "1255700514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1202 MORENA BLVD STE 300",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921103844",
"telephone_number": "619-276-8112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1202 MORENA BLVD STE 300",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921103844",
"telephone_number": "619-276-8112"
}
],
"practiceLocations": [
{
"address_1": "637 3rd Ave Ste I",
"address_purpose": "LOCATION",
"city": "Chula Vista",
"state": "CA",
"postal_code": "919105707",
"country_code": "US",
"telephone_number": "818-618-1100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3002 Armstrong St",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "92111",
"country_code": "US",
"telephone_number": "858-277-9550",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3002 Armstrong St",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "92111",
"country_code": "US",
"telephone_number": "858-277-9550",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ACEVEDO",
"first_name": "NANCY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-16",
"last_updated": "2021-08-02",
"certification_date": "2021-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "117819",
"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 Aug 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.