Saul Joaquin Estavillo, MFT-INTERN

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMF69470 Issued in CA

Practice address

3322 Sweetwater Springs Blvd
102
Spring Valley, CA 91977-3162

Phone

(619) 993-7313

Fax

(619) 670-0060

NPI assigned

Jan 30, 2012

Last updated

Feb 4, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Specialty

Marriage and Family Therapist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centro de Salud de la Comunidad de San Ysidro,Inc.Group PAC ID 6901709435, 291 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Centro de Salud de la Comunidad de San Ysidro, Inc.

  dba San Ysidro Health Precision Park

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1124782685
  Medicare reassignment Care Compare group NPD
• Centro de Salud de la Comunidad de San Ysidro Inc

  dba San Ysidro Health Senior Dental Center

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1457033813
  NPD
• Centro de Salud de la Comunidad de San Ysidro, Inc.

  dba San Ysidro Health Escondido Family Medicine

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
  • NPI 1801438239
  NPD

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

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1528330073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5337 VISTA SANTA MARGARITA",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921545515",
            "telephone_number": "619-410-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3322 SWEETWATER SPRINGS BLVD",
            "address_2": "102",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "919773162",
            "telephone_number": "619-993-7313",
            "fax_number": "619-670-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTAVILLO",
        "first_name": "SAUL",
        "middle_name": "JOAQUIN",
        "credential": "MFT-INTERN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-30",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF69470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Portia Ellard
• Austin James Elliott, PHARMD
• Emg
• Encompass Family Physician Medical Group
• Paolo Sal Errico
• Denise D Evangelista, PT, DPT
• Mark A Evinger, DDS DENTIST
• Latoya Facey
• Family Health Centers of San Diego
• Family Health Centers of San Diego (Grossmont Spring Valley Family Health Center)

• Marriage & Family Therapist in Spring Valley, CA
• Providers in Spring Valley, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.