Active NPI
Jennifer Fastiggi
- Mental Health Counselor
- Lemon Grove, CA
National Provider Identifier
1669917886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- ASW73861
- Practice address
- 3434 Grove St
Lemon Grove, CA 91945-1812 - Phone
- (845) 642-1743
- NPI assigned
- Dec 23, 2016
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | ASW73861 | CA | Primary |
Addresses
Primary practice location
3434 Grove St
Lemon Grove, CA 91945-1812
Mailing address
3434 Grove St
Lemon Grove, CA 91945-1812
Phone (845) 642-1743
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW73861 | CA | MD | Mental Health Counselor |
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1482451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482451200000",
"number": "1669917886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3434 GROVE ST",
"city": "LEMON GROVE",
"state": "CA",
"postal_code": "919451812",
"telephone_number": "845-642-1743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3434 GROVE ST",
"city": "LEMON GROVE",
"state": "CA",
"postal_code": "919451812",
"telephone_number": "845-642-1743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FASTIGGI",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-23",
"last_updated": "2016-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "ASW73861",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lemon Grove, CA
- Family Health Centers of San Diego, Inc
- Family Health Centers of San Diego, Inc
- Family Health Centers of San Diego, Inc
- Family Health Centers of San Diego, Inc
- Family Health Centers of San Diego, Inc
- Shaynna Ryanne Fausett
- Tomas Robert Fernandez
- Fidare Health Co
- Tyia Vanessa Fields, LVN
- David Eaton Fleming, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.