Individual provider Active NPI

Amanda Elise Cisneros, LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1558866913
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
132697 Issued in CA
Practice address
5555 Reservoir Dr Ste 309
San Diego, CA 92120-5193
Phone
(888) 588-8995
Fax
(510) 756-0812
NPI assigned
Mar 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X 132697 CA Primary

Addresses

Primary practice location

5555 Reservoir Dr Ste 309
San Diego, CA 92120-5193

Mailing address

5555 Reservoir Dr Ste 309
San Diego, CA 92120-5193
Phone (888) 588-8995

Other practice location 1

1000 G St Ste 125
Sacramento, CA 95814-0894
Phone (888) 588-8995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1558866913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 RESERVOIR DR STE 309",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205193",
            "telephone_number": "888-588-8995",
            "fax_number": "510-756-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 RESERVOIR DR STE 309",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205193",
            "telephone_number": "888-588-8995",
            "fax_number": "510-756-0812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 G St Ste 125",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958140894",
            "country_code": "US",
            "telephone_number": "888-588-8995",
            "fax_number": "510-756-0812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CISNEROS",
        "first_name": "AMANDA",
        "middle_name": "ELISE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-28",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "132697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.