Jessica Davanzo, MFT, M.ED

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

11770 Bernardo Plaza CT Ste 370
San Diego, CA 92128-2426

Phone

(858) 673-3360

Fax

(619) 528-4625

NPI assigned

Jun 15, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Psychiatric Centers at San Diego, Inc. Med GRP

  • Mental Health Counselor
  • San Diego, CA
  • NPI 1841241585

  Marriage & Family Therapist

  NPD (past)

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1316142805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 609001",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921609001",
            "telephone_number": "619-528-4600",
            "fax_number": "619-528-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11770 BERNARDO PLAZA CT STE 370",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282426",
            "telephone_number": "858-673-3360",
            "fax_number": "619-528-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVANZO",
        "first_name": "JESSICA",
        "name_prefix": "Ms.",
        "credential": "MFT, M.ED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Catherine Davalos Sorto, LCSW
• Ariel Richard Davalos
• Georgina Davalos
• Johanna Summer Davalos, RN
• Ariea Davani, MD
• Dave Auluck MD PC
• Edrika Lanay Dave
• Shravan Dave, MD
• Arpna Vajpayee Dave', M.D.
• Jeni D Davenport-Furniss, NBC-HWC, CHES

• Marriage & Family Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; 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.