Active NPI
Julia J Gendron, MFT
- Marriage & Family Therapist
- San Diego, CA
National Provider Identifier
1497942981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 42655
- Practice address
- 9655 Granite Ridge Dr
Sixth Floor
San Diego, CA 92123-2674 - Phone
- (805) 713-5930
- NPI assigned
- Sep 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 42655 | CA | Primary |
Addresses
Primary practice location
9655 Granite Ridge Dr
Sixth Floor
San Diego, CA 92123-2674
Mailing address
9655 Granite Ridge Drive
Sixth Floor
San Diego, CA 92123
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
| License | State | Type | Specialty |
|---|---|---|---|
| 42655 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190851200000",
"number": "1497942981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9655 GRANITE RIDGE DRIVE",
"address_2": "SIXTH FLOOR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9655 GRANITE RIDGE DR",
"address_2": "SIXTH FLOOR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921232674",
"telephone_number": "805-713-5930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENDRON",
"first_name": "JULIA",
"middle_name": "J",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-27",
"last_updated": "2007-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "42655",
"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 Sep 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.