Organization Active NPI

Behavioral Mental Health PC

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1609828755
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
BEHAVIORAL MENTAL HEALTH PC
Practice address
3111 Camino del Rio N Ste 400
San Diego, CA 92108-5724
Phone
(858) 205-5486
NPI assigned
May 17, 2006
Last updated
Jun 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Authorized official

Name
Dr. Marjan Davoudi, PSY. D.NPI 1174575245
Title
Owner
Phone
(858) 205-5486

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 060009174 IL
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary
Health Service Clinic/Center 261QH0100X

Addresses

Primary practice location

3111 Camino del Rio N Ste 400
San Diego, CA 92108-5724

Mailing address

PO Box 2585
La Jolla, CA 92038-2585
Phone (858) 205-5486

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100913000634 CA Part B Supplier - Clinic/Group Practice 4981615192 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

3262 Holiday Ct
Ste 220
La Jolla, CA 92037
Phone (858) 205-5486

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": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782259200000",
    "number": "1609828755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2585",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920382585",
            "telephone_number": "858-205-5486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 CAMINO DEL RIO N STE 400",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921085724",
            "telephone_number": "858-205-5486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL MENTAL HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A",
        "authorized_official_last_name": "DAVOUDI",
        "authorized_official_first_name": "MARJAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-205-5486",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY. D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "IL",
            "license": "060009174",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Jun 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.