Audrey Naomi Defrisco, M.S.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LMFT132113 Issued in CA

Practice address

441 Marsh St
San Luis Obispo, CA 93401

Phone

(805) 305-3695

Fax

(805) 543-0859

NPI assigned

Dec 7, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Audrey Naomi Pearce Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Slo County Family Therapy Inc.

  • Mental Health Counselor
  • San Luis Obispo, CA
  • NPI 1144855339
  NPD (past)

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

{
    "created_epoch": "1544140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1447721063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 MARSH ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93401",
            "telephone_number": "805-305-3695",
            "fax_number": "805-543-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 MARSH ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93401",
            "telephone_number": "805-305-3695",
            "fax_number": "805-543-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFRISCO",
        "first_name": "AUDREY",
        "middle_name": "NAOMI",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-07",
        "last_updated": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "110475",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "LMFT132113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDREY",
            "last_name": "PEARCE",
            "middle_name": "NAOMI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel Dearborn
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• Kimberly Declercq
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• Amber Deem
• Jennifer Degarmo
• Degroot Nursing Home
• Dimitri Delagrammaticas, MD
• Joy L Delaluna, PT
• Edward C Delgadillo

• Psychologist in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.