Individual provider Active NPI

Stephanie Dyan Freiburg, LMFT 52486

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1285820563
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
52486 Issued in CA
Practice address
2986 Ivy St
San Diego, CA 92104-5552
Phone
(619) 537-9875
NPI assigned
Sep 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 52486 CA Primary

Addresses

Primary practice location

2986 Ivy St
San Diego, CA 92104-5552

Mailing address

2986 Ivy St
San Diego, CA 92104-5552
Phone (619) 537-9875

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 4, 2026 through May 4, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
52486CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1285820563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2986 IVY ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921045552",
            "telephone_number": "619-537-9875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2986 IVY ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921045552",
            "telephone_number": "619-537-9875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREIBURG",
        "first_name": "STEPHANIE",
        "middle_name": "DYAN",
        "name_prefix": "Mrs.",
        "credential": "LMFT 52486",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-19",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "52486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.