Active NPI
Lisa Marie, M.A.
- Marriage & Family Therapist
- San Diego, CA
National Provider Identifier
1629442579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 90073
- Practice address
- 5650 Mount Ackerly Dr
San Diego, CA 92111-4016 - Phone
- (858) 496-8205
- NPI assigned
- Nov 16, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 90073 | CA | Primary |
Addresses
Primary practice location
5650 Mount Ackerly Dr
San Diego, CA 92111-4016
Mailing address
2351 Cardinal LN
San Diego, CA 92123-3743
Phone (858) 496-8205
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 90073 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447632000000",
"number": "1629442579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2351 CARDINAL LN",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921233743",
"telephone_number": "858-496-8205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5650 MOUNT ACKERLY DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921114016",
"telephone_number": "858-496-8205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARIE",
"first_name": "LISA",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-16",
"last_updated": "2015-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "90073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
- Margaux Bianca Mariano, OTD
- Rachele Angela Mariano, DDS
- Robert Mariano, L.AC.
- Cristina A Marichi
- Marie a. Moeckel, DDS Inc
- Megan Marie, ND
- Sarah Rebecca Marietti Shepherd, M.D.
- Mariflor Duhay DDS a Dental Corporation
- Marika Peckham, Licensed Clinical Social Worker, Apc
- Marilee L.M. Wasell, PH.D. Clinical and Consulting Psychology PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.