Fedra Arellano

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

6160 Mission Gorge Rd Ste 100
San Diego, CA 92120-3425

Phone

(619) 381-7955

NPI assigned

May 17, 2020

Last updated

Jun 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1589673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1558983114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6160 MISSION GORGE RD STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921203425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 MISSION GORGE RD STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921203425",
            "telephone_number": "619-381-7955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARELLANO",
        "first_name": "FEDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-17",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "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": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390200000X",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "http://www.kickstartsd.org/",
            "affiliation": "N",
            "address_1": "6160 Mission Gorge Rd Ste 100",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921203425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cassandra Marie Arellano
• Connor Arellano, DO
• Daniel Juarez Arellano, OTR/L
• Emely Arellano
• Emkae Arellano
• Fumi Judith Arellano, P.T.
• Jacqueline Arellano
• Lindsay Jiron Arellano, FNP
• Maria Elena Arellano
• Maria Rosalia Arellano, MSPT, NCS

• Student in an Organized Health Care Education/Training Program in San Diego, CA
• Providers in San Diego, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; 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.