Individual provider Active NPI

Gianni Demichele, LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1396388245
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
110018 Issued in CA
Practice address
2729 4TH Ave Ste 3
San Diego, CA 92103-6223
Phone
(610) 393-3078
NPI assigned
Oct 23, 2019
Reactivated
Sep 28, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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 110018 CA Primary

Addresses

Primary practice location

2729 4TH Ave Ste 3
San Diego, CA 92103-6223

Mailing address

4381 10TH Ave
San Diego, CA 92103-2306
Phone (610) 393-3078

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

NPI Registry JSON

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

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1396388245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4381 10TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032306",
            "telephone_number": "610-393-3078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2729 4TH AVE STE 3",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921036223",
            "telephone_number": "610-393-3078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMICHELE",
        "first_name": "GIANNI",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-23",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "deactivation_date": "2020-03-30",
        "reactivation_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "110018",
            "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 Sep 28, 2022; 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.