Individual provider Active NPI

Ebonee Alyssa Simmons, MFT

  • Marriage & Family Therapist
  • El Cajon, CA
National Provider Identifier
1306298179
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
156039 Issued in CA
Practice address
1664 Broadway
El Cajon, CA 92021-5201
Phone
(619) 579-8685
NPI assigned
Jul 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X 124505 CA
Marriage & Family Therapist 106H00000X 142972 CA
Marriage & Family Therapist 106H00000X 156039 CA Primary

Addresses

Primary practice location

1664 Broadway
El Cajon, CA 92021-5201

Mailing address

1664 Broadway
El Cajon, CA 92021-5201

Other practice location 1

409 Camino Del Rio S Ste 201
San Diego, CA 92108-3505
Phone (619) 381-7748

Other practice location 2

2130 National Ave
San Diego, CA 92113-2209
Phone (619) 515-2338

Other practice location 3

8755 Aero Dr Ste 230
San Diego, CA 92123-1750
Phone (858) 256-2180

Other identifiers 1

IdentifierTypeStateIssuer
3737810MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250729003170 CA Practitioner - Marriage and Family Therapist 3173030640 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
124505CAMDSocial Worker
142972CAMDMarriage & Family Therapist
156039CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc. CurrentSince Jul 1, 2025 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Jul 1, 2025 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
New Alternatives, Incorporated PastSince Sep 1, 2021 Accepting new patients

Locations

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1306298179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1664 BROADWAY",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920215201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1664 BROADWAY",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920215201",
            "telephone_number": "619-579-8685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "409 Camino Del Rio S Ste 201",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921083505",
            "country_code": "US",
            "telephone_number": "619-381-7748",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2130 National Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921132209",
            "country_code": "US",
            "telephone_number": "619-515-2338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8755 Aero Dr Ste 230",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921231750",
            "country_code": "US",
            "telephone_number": "858-256-2180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "EBONEE",
        "middle_name": "ALYSSA",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-05",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "124505",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "142972",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "156039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3737810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

Verify at the official NPI Registry.