Organization Active NPI

Resilient Roots Therapy PC

  • Adult Mental Health Clinic/Center
  • San Diego, CA
National Provider Identifier
1598696577
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
RESILIENT ROOTS THERAPY PC
Practice address
6555 Ambrosia Dr
San Diego, CA 92124-3226
Phone
(213) 537-2874
NPI assigned
May 27, 2026
Last updated
May 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Authorized official

Name
Ashanti Miranda, LCSWNPI 1528779733
Title
Owner/Operator
Phone
(213) 537-2874

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

6555 Ambrosia Dr
San Diego, CA 92124-3226

Mailing address

1050 University Ave Ste 107
San Diego, CA 92103-3359
Phone (213) 537-2874

National Provider Directory

National Provider Directory

Locations

1050 University Ave
Ste 107
San Diego, CA 92103

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1779840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779840000000",
    "number": "1598696577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 UNIVERSITY AVE STE 107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033359",
            "telephone_number": "213-537-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6555 AMBROSIA DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921243226",
            "telephone_number": "213-537-2874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIENT ROOTS THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-27",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A",
        "authorized_official_last_name": "MIRANDA",
        "authorized_official_first_name": "ASHANTI",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "213-537-2874",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "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 May 27, 2026; 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.