Individual provider Active NPI

Jennifer Siddons, LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1467649285
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
135405 Issued in CA
Practice address
4909 Murphy Canyon Rd Ste 300
San Diego, CA 92123-4301
Phone
(858) 268-9800
Fax
(858) 268-9810
NPI assigned
Sep 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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 135405 CA Primary

Addresses

Primary practice location

4909 Murphy Canyon Rd Ste 300
San Diego, CA 92123-4301

Mailing address

4909 Murphy Canyon Rd Ste 300
San Diego, CA 92123-4301
Phone (858) 268-9800

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
I20241119002482 CA Practitioner - Marriage and Family Therapist 9830624519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4909 Murphy Canyon Rd
Suite 300
San Diego, CA 92123-4301
Phone (858) 268-9800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Connections Counseling, a Psychological Corporation CurrentSince Nov 1, 2024 Accepting new patients

Locations

4909 Murphy Canyon Rd
Ste 300
San Diego, CA 92123
Phone (858) 268-9800

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1467649285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 MURPHY CANYON RD STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234301",
            "telephone_number": "858-268-9800",
            "fax_number": "858-268-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4909 MURPHY CANYON RD STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234301",
            "telephone_number": "858-268-9800",
            "fax_number": "858-268-9810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDONS",
        "first_name": "JENNIFER",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-25",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "135405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.