Individual provider Active NPI

Cassidy Freitas, PH.D., LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1497204796
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT91256 Issued in CA
Practice address
4540 Kearny Villa Rd Ste 210
San Diego, CA 92123-1586
Phone
(858) 480-5314
NPI assigned
Sep 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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 LMFT91256 CA Primary

Addresses

Primary practice location

4540 Kearny Villa Rd Ste 210
San Diego, CA 92123-1586

Mailing address

4540 Kearny Villa Rd Ste 210
San Diego, CA 92123-1586
Phone (858) 480-5314

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LMFT91256CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Freitas Family Therapy Inc Marriage & Family Therapist CurrentSince Oct 8, 2023 Accepting new patients

Locations

4540 Kearny Villa Rd
Ste 210
San Diego, CA 92123
Phone (858) 480-5314

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": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1497204796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 KEARNY VILLA RD STE 210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231586",
            "telephone_number": "858-480-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 KEARNY VILLA RD STE 210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231586",
            "telephone_number": "858-480-5314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREITAS",
        "first_name": "CASSIDY",
        "name_prefix": "Dr.",
        "credential": "PH.D., LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-27",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT91256",
            "primary": true
        }
    ],
    "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 Mar 10, 2023; 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.