Active NPI
Jennifer A McCormick, MA
- Marriage & Family Therapist
- Poway, CA
National Provider Identifier
1710162672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC48233
- Practice address
- 15611 Pomerado Rd
Ste 535
Poway, CA 92064-2437 - Phone
- (858) 272-6100
- NPI assigned
- Jan 9, 2008
- Last updated
- Aug 14, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | MFC48233 | CA | Primary |
Addresses
Primary practice location
15611 Pomerado Rd
Ste 535
Poway, CA 92064-2437
Mailing address
4550 Kearny Villa Rd
Suite 116
San Diego, CA 92123-1578
Phone (858) 279-1223
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 |
|---|---|---|---|
| MFC48233 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Marriage & Family Therapist | Current | Accepting new patients |
Interoperability endpoints
- jennifermccormick@tdh.allscriptsdirect.net
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
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- Lewisville, TX
- NPI 1245403567
Marriage & Family Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407974400000",
"number": "1710162672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4550 KEARNY VILLA RD",
"address_2": "SUITE 116",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231578",
"telephone_number": "858-279-1223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15611 POMERADO RD",
"address_2": "STE 535",
"city": "POWAY",
"state": "CA",
"postal_code": "920642437",
"telephone_number": "858-272-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORMICK",
"first_name": "JENNIFER",
"middle_name": "A",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-09",
"last_updated": "2014-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC48233",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poway, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.