Individual provider Active NPI

Mitra Marie Naima, LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1457684250
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT84370 Issued in CA
Practice address
1401 Broadway
San Diego, CA 92101-5710
Phone
(619) 276-8112
Fax
(619) 276-8230
NPI assigned
Sep 10, 2009
Last updated
Apr 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT84370 CA Primary
Rehabilitation Practitioner 225400000X NU

Addresses

Primary practice location

1401 Broadway
San Diego, CA 92101-5710

Mailing address

PO Box 421141
San Diego, CA 92142-1141
Phone (619) 276-8112

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

LicenseStateTypeSpecialty
LMFT84370CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Research Foundation Inc PastSince Apr 21, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1252540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1457684250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421141",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921421141",
            "telephone_number": "619-276-8112",
            "fax_number": "619-276-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 BROADWAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921015710",
            "telephone_number": "619-276-8112",
            "fax_number": "619-276-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIMA",
        "first_name": "MITRA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-10",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT84370",
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 18, 2024; 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.