Individual provider Active NPI

Christina Estrada-Samaniego, LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1386948628
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
121311 Issued in CA
Practice address
1202 Morena Blvd Ste 300
San Diego, CA 92110-3844
Phone
(619) 276-8112
NPI assigned
Dec 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Behavior Analyst 103K00000X
Marriage & Family Therapist 106H00000X 71467 CA
Marriage & Family Therapist 106H00000X 121311 CA Primary

Addresses

Primary practice location

1202 Morena Blvd Ste 300
San Diego, CA 92110-3844

Mailing address

1202 Morena Blvd Ste 300
San Diego, CA 92110-3844
Phone (619) 276-8112

Other practice location 1

202 N 8th St
El Centro, CA 92243-2302
Phone (760) 482-4000

Other practice location 2

1465 30th St Ste K
San Diego, CA 92154-3497
Phone (619) 428-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL email Direct

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
I20240703003346 CA Practitioner - Marriage and Family Therapist 7517401300 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71467CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince May 21, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince May 21, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

Organizations & group practices 3

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": "1293667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1386948628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MORENA BLVD STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103844",
            "telephone_number": "619-276-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 MORENA BLVD STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103844",
            "telephone_number": "619-276-8112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "202 N 8th St",
            "address_purpose": "LOCATION",
            "city": "El Centro",
            "state": "CA",
            "postal_code": "922432302",
            "country_code": "US",
            "telephone_number": "760-482-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1465 30th St Ste K",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921543497",
            "country_code": "US",
            "telephone_number": "619-428-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTRADA-SAMANIEGO",
        "first_name": "CHRISTINA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-30",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "71467",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "121311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "email",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1202 Morena Blvd Ste 300",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921103844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.