NPIMap

Organization Active NPI

Jennifer Lundy Family Therapy, Inc.

Doing business as Positive Change Counseling Center

  • Clinical Psychologist
  • La Mesa, CA
National Provider Identifier
1427320605
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
21402 Issued in CA
Legal business name
JENNIFER LUNDY FAMILY THERAPY, INC.
Doing business as
Positive Change Counseling Center
Practice address
5480 Baltimore Dr Ste 250
La Mesa, CA 91942-2066
Phone
(619) 733-6414
Fax
(619) 303-3306
NPI assigned
Feb 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

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

Authorized official

Name
Jennifer Lynn Lundy-Aguerre, MFTNPI 1891881793
Title
Owner
Phone
(619) 733-6414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X 21402 CA Primary
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X 42025 CA

Addresses

Primary practice location

5480 Baltimore Dr Ste 250
La Mesa, CA 91942-2066

Mailing address

5480 Baltimore Dr Ste 250
La Mesa, CA 91942-2066
Phone (619) 733-6414

Other names 1

  • Positive Change Counseling Center Doing business as

National Provider Directory

National Provider Directory

Locations

5480 Baltimore Dr
Ste 250
La Mesa, CA 91942
Phone (619) 733-6414

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394582400000",
    "number": "1427320605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5480 BALTIMORE DR STE 250",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422066",
            "telephone_number": "619-733-6414",
            "fax_number": "619-303-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 BALTIMORE DR STE 250",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422066",
            "telephone_number": "619-733-6414",
            "fax_number": "619-303-3306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER LUNDY FAMILY THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-02",
        "last_updated": "2014-03-12",
        "status": "A",
        "authorized_official_last_name": "LUNDY-AGUERRE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-733-6414",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "21402",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "42025",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Positive Change Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; 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.