Individual provider Active NPI

Gary Hittle, MFT, PN.D.

  • Marriage & Family Therapist
  • La Mesa, CA
National Provider Identifier
1710144217
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC7065 Issued in CA
Practice address
5480 Baltimore Dr Ste 202
La Mesa, CA 91942-2015
Phone
(619) 464-7771
Fax
(619) 464-7772
NPI assigned
May 21, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC7065 CA Primary

Addresses

Primary practice location

5480 Baltimore Dr Ste 202
La Mesa, CA 91942-2015

Mailing address

5480 Baltimore Dr Ste 202
La Mesa, CA 91942-2015
Phone (619) 464-7771

Other identifiers 1

IdentifierTypeStateIssuer
1679655369OtherCAGROUP NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240810000305 CA Practitioner - Marriage and Family Therapist 3971041823

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5480 Baltimore Dr
Suite 202
La Mesa, CA 91942-2015
Phone (619) 933-4356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFC7065CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gary D Hittle PHD Marriage & Family Therapist CurrentSince May 8, 2024 Accepting new patients

Locations

5480 Baltimore Dr
Ste 202
La Mesa, CA 91942
Phone (619) 933-4356

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": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1710144217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5480 BALTIMORE DR STE 202",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422015",
            "telephone_number": "619-464-7771",
            "fax_number": "619-464-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 BALTIMORE DR STE 202",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422015",
            "telephone_number": "619-464-7771",
            "fax_number": "619-464-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HITTLE",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "MFT, PN.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC7065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1679655369",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.