Active NPI
Iliana Ruth Berezovsky, MFT
- Marriage & Family Therapist
- San Diego, CA
National Provider Identifier
1386146983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 31865
- Practice address
- 3555 Kenyon St Ste 101
San Diego, CA 92110-5341 - Phone
- (858) 705-4211
- NPI assigned
- Feb 28, 2018
- 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 | 31865 | CA | Primary |
Addresses
Primary practice location
3555 Kenyon St Ste 101
San Diego, CA 92110-5341
Mailing address
5441 Caminito Exquisito
San Diego, CA 92130-2825
Phone (858) 705-4211
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31865 | CA | MD | Certified Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519776000000",
"number": "1386146983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5441 CAMINITO EXQUISITO",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921302825",
"telephone_number": "858-705-4211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3555 KENYON ST STE 101",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921105341",
"telephone_number": "858-705-4211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEREZOVSKY",
"first_name": "ILIANA",
"middle_name": "RUTH",
"credential": "MFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-28",
"last_updated": "2018-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "31865",
"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 Feb 28, 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.