Individual provider Active NPI

Jennine Elise Powell, M.A., M.F.T.

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1619204831
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC#47653 Issued in CA
Practice address
3333 Camino del Rio S Ste 215
San Diego, CA 92108-3837
Phone
(619) 471-7104
Fax
(619) 297-4496
NPI assigned
Nov 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LF61451096 WA
Marriage & Family Therapist 106H00000X MFC#47653 CA Primary

Addresses

Primary practice location

3333 Camino del Rio S Ste 215
San Diego, CA 92108-3837

Mailing address

3333 Camino del Rio S Ste 215
San Diego, CA 92108-3837
Phone (619) 558-0001

Other practice location 1

705 W 7th Ave Ste A-2
Spokane, WA 99204-2836
Phone (509) 418-2980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 23, 2024 through Feb 23, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC#47653CAMDMarriage & Family Therapist
LF61451096WAMDMarriage & Family Therapist
47653CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Spokane Counseling Hub Current 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": "1257724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1619204831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 CAMINO DEL RIO S STE 215",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083837",
            "telephone_number": "619-558-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 CAMINO DEL RIO S STE 215",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083837",
            "telephone_number": "619-471-7104",
            "fax_number": "619-297-4496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 W 7th Ave Ste A-2",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992042836",
            "country_code": "US",
            "telephone_number": "509-418-2980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWELL",
        "first_name": "JENNINE",
        "middle_name": "ELISE",
        "name_prefix": "Mrs.",
        "credential": "M.A., M.F.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-09",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF61451096",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC#47653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.