Individual provider Active NPI

Cameron Eleanor Anderson, M.A.

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1306072632
Registry record updated Mar 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMF63279 Issued in CA
Practice address
2535 Kettner Blvd
Suite 1a-4
San Diego, CA 92101-1250
Phone
(619) 615-0701
Fax
(619) 615-0705
NPI assigned
Jun 1, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2011

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 IMF63279 CA Primary

Addresses

Primary practice location

2535 Kettner Blvd
Suite 1a-4
San Diego, CA 92101-1250

Mailing address

7739 San Vicente St
San Diego, CA 92114-4736
Phone (619) 889-4570

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

LicenseStateTypeSpecialty
IMF63279CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299715200000",
    "number": "1306072632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7739 SAN VICENTE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921144736",
            "telephone_number": "619-889-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 KETTNER BLVD",
            "address_2": "SUITE 1A-4",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921011250",
            "telephone_number": "619-615-0701",
            "fax_number": "619-615-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CAMERON",
        "middle_name": "ELEANOR",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-01",
        "last_updated": "2011-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF63279",
            "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 Mar 10, 2011; 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.