Active NPI
Mansoureh Poulin, MFT
- Marriage & Family Therapist
- San Diego, CA
National Provider Identifier
1407989098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 50537
- Practice address
- 3511 Camino del Rio S Ste 303
San Diego, CA 92108-4043 - Phone
- (619) 630-7793
- NPI assigned
- Mar 13, 2007
- 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 | 50537 | CA | Primary |
Addresses
Primary practice location
3511 Camino del Rio S Ste 303
San Diego, CA 92108-4043
Mailing address
3511 Camino del Rio S Ste 303
San Diego, CA 92108-4043
Phone (619) 630-7793
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 |
|---|---|---|---|
| 50537 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hilber Psychological Services a Professional Corporation | Marriage & Family Therapist | Past | Accepting new patients |
| Tanya L. Hilber, PSYD | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Psychologist
- San Diego, CA
- NPI 1528822434
Marriage & Family Therapist
-
- Clinical Psychologist
- San Diego, CA
- NPI 1962807628
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555891200000",
"number": "1407989098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3511 CAMINO DEL RIO S STE 303",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921084043",
"telephone_number": "619-630-7793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3511 CAMINO DEL RIO S STE 303",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921084043",
"telephone_number": "619-630-7793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POULIN",
"first_name": "MANSOUREH",
"credential": "MFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-13",
"last_updated": "2019-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "50537",
"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 Apr 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.