Individual provider Active NPI

Stacey Sciacchitano, M.ED.; LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1710230396
Registry record updated Oct 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 52234 Issued in CA
Practice address
10065 Old Grove Rd
200
San Diego, CA 92131-1664
Phone
(858) 444-8823
Fax
(858) 444-8827
NPI assigned
Oct 19, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2012

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 MFC 52234 CA Primary

Addresses

Primary practice location

10065 Old Grove Rd
200
San Diego, CA 92131-1664

Mailing address

10065 Old Grove Rd
200
San Diego, CA 92131-1664
Phone (858) 444-8823

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC 52234CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350604800000",
    "number": "1710230396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10065 OLD GROVE RD",
            "address_2": "200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311664",
            "telephone_number": "858-444-8823",
            "fax_number": "858-444-8827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10065 OLD GROVE RD",
            "address_2": "200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311664",
            "telephone_number": "858-444-8823",
            "fax_number": "858-444-8827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCIACCHITANO",
        "first_name": "STACEY",
        "credential": "M.ED.; LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-19",
        "last_updated": "2012-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 52234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.