Individual provider Active NPI

John Robert Ackerman, MFT

  • Marriage & Family Therapist
  • San Clemente, CA
National Provider Identifier
1467484402
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
38629 Issued in CA
Practice address
3551 Camino Mira Costa
Suite K
San Clemente, CA 92672-3508
Phone
(949) 606-5398
NPI assigned
Jul 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 38629 CA Primary

Addresses

Primary practice location

3551 Camino Mira Costa
Suite K
San Clemente, CA 92672-3508

Mailing address

3551 Camino Mira Costa
Suite K
San Clemente, CA 92672-3529
Phone (949) 606-5398

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240105004356 CA Practitioner - Marriage and Family Therapist 0446601116 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sokyahealth Medical Group PCGroup PAC ID 8628463015, 180 clinicians

Practice addresses (Care Compare)

5060 Shoreham PL
Suite 330
San Diego, CA 92122-5976
Phone (858) 427-5060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sokyahealth Medical Group PC Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients

Locations

2386 Faraday Ave
Ste 110
Carlsbad, CA 92008
Phone (858) 427-5060

5060 Shoreham Pl
Ste 330
San Diego, CA 92122
Phone (619) 866-0998

Interoperability endpoints

  • Direct secure messaging: michael.falcone.d1.p1@direct.sokya.nextgenshare.com

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, 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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467484402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 CAMINO MIRA COSTA",
            "address_2": "SUITE K",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926723529",
            "telephone_number": "949-606-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 CAMINO MIRA COSTA",
            "address_2": "SUITE K",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926723508",
            "telephone_number": "949-606-5398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "38629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.