Individual provider Active NPI

Robert Wayne Poor, LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1528287968
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC19092 Issued in CA
Practice address
3853 Rosecrans St
San Diego, CA 92110-3115
Phone
(619) 692-8220
Fax
(619) 692-5535
NPI assigned
Apr 24, 2007
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 MFC19092 CA Primary

Addresses

Primary practice location

3853 Rosecrans St
San Diego, CA 92110-3115

Mailing address

PO Box 16162
San Diego, CA 92176-6162

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
MFC19092CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528287968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16162",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921766162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3853 ROSECRANS ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103115",
            "telephone_number": "619-692-8220",
            "fax_number": "619-692-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOR",
        "first_name": "ROBERT",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC19092",
            "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 Jul 8, 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.

Verify at the official NPI Registry.