Active NPI
Victoria A Tavitian
- Marriage & Family Therapist
- San Diego, CA
National Provider Identifier
1548978463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 133912
- Practice address
- 4849 Ronson CT Ste 207
San Diego, CA 92111-1805 - Phone
- (844) 737-3638
- NPI assigned
- Nov 9, 2022
- 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 | 133912 | CA | Primary |
Addresses
Primary practice location
4849 Ronson CT Ste 207
San Diego, CA 92111-1805
Mailing address
321 S 6TH St Apt 110
Burbank, CA 91501-3102
Phone (818) 748-5890
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 |
|---|---|---|---|
| 133912 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Serene Health | Single Specialty | Past | Accepting new patients |
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": "1667952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667952000000",
"number": "1548978463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 S 6TH ST APT 110",
"city": "BURBANK",
"state": "CA",
"postal_code": "915013102",
"telephone_number": "818-748-5890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4849 RONSON CT STE 207",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921111805",
"telephone_number": "844-737-3638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAVITIAN",
"first_name": "VICTORIA",
"middle_name": "A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-09",
"last_updated": "2022-11-09",
"certification_date": "2022-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "133912",
"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 Nov 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.