Individual provider Active NPI

Ian Taylor

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1548705262
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
93876 Issued in CA
Practice address
17584 Caminito Canasto
San Diego, CA 92127-1149
Phone
(760) 846-3035
NPI assigned
Jan 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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 93876 CA Primary

Addresses

Primary practice location

17584 Caminito Canasto
San Diego, CA 92127-1149

Mailing address

17584 Caminito Canasto
San Diego, CA 92127-1149
Phone (760) 846-3035

Other identifiers 1

IdentifierTypeStateIssuer
106H00000XOtherCAHTTP://WWW.WPC-EDI.COM/REFERENCE/CODELISTS/HEALTHCARE/HEALTH-CARE-PROVIDER-TAXON

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
I20240522000991 CA Practitioner - Marriage and Family Therapist 1355787680 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
93876CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cyti Health PC CurrentSince Mar 27, 2024 Accepting new patients

Locations

11801 Pierce St
Riverside, CA 92505
Phone (909) 528-0317

3111 Camino del Rio N
Ste 460
San Diego, CA 92108

402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939

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": "1483488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1548705262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17584 CAMINITO CANASTO",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271149",
            "telephone_number": "760-846-3035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17584 CAMINITO CANASTO",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271149",
            "telephone_number": "760-846-3035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "IAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-04",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "93876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HTTP://WWW.WPC-EDI.COM/REFERENCE/CODELISTS/HEALTHCARE/HEALTH-CARE-PROVIDER-TAXON",
            "identifier": "106H00000X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.