Active NPI
Fortitude Marriage and Family Therapy Incorporated
- Marriage & Family Therapist
- San Luis Obispo, CA
National Provider Identifier
1730947441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Legal business name
- FORTITUDE MARRIAGE AND FAMILY THERAPY INCORPORATED
- Practice address
- 11549 Los Osos Valley Rd Ste 103
San Luis Obispo, CA 93405-6457 - Phone
- (805) 235-7792
- NPI assigned
- Mar 7, 2024
- Organization subpart
- Yes
- Parent organization
- FORTITUDE MARRIAGE AND FAMILY THERAPY INCORPORATED
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gino Anthony Memoli III
- Title
- Ceo
- Phone
- (805) 235-7792
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | Primary |
Addresses
Primary practice location
11549 Los Osos Valley Rd Ste 103
San Luis Obispo, CA 93405-6457
Mailing address
11549 Los Osos Valley Rd Ste 103
San Luis Obispo, CA 93405-6457
Phone (805) 235-7792
Other names 1
- Fortitude Therapy Collective
National Provider Directory
National Provider Directory- Part of
- Fortitude Marriage and Family Therapy Incorporated
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Marriage & Family Therapist
- San Luis Obispo, CA
- NPI 1285333252
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709769600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1772064000000",
"number": "1730947441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11549 LOS OSOS VALLEY RD STE 103",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934056457",
"telephone_number": "805-235-7792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11549 LOS OSOS VALLEY RD STE 103",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934056457",
"telephone_number": "805-235-7792"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FORTITUDE MARRIAGE AND FAMILY THERAPY INCORPORATED",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "FORTITUDE MARRIAGE AND FAMILY THERAPY INCORPORATED",
"enumeration_date": "2024-03-07",
"last_updated": "2026-02-26",
"certification_date": "2026-02-26",
"status": "A",
"authorized_official_last_name": "MEMOLI",
"authorized_official_first_name": "GINO",
"authorized_official_middle_name": "ANTHONY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "805-235-7792",
"authorized_official_name_suffix": "III"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Fortitude Therapy Collective",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.