Individual provider Active NPI

Tammy Lynn Carter, M.A.

  • Marriage & Family Therapist
  • El Cajon, CA
National Provider Identifier
1770093577
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
117201 Issued in CA
Practice address
771 Jamacha Road, #243
El Cajon, CA 92019
Phone
(619) 396-0367
Fax
(760) 919-3132
NPI assigned
Oct 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMF954436 CA
Marriage & Family Therapist 106H00000X 117201 CA Primary

Addresses

Primary practice location

771 Jamacha Road, #243
El Cajon, CA 92019

Mailing address

771 Jamacha Rd # 243
El Cajon, CA 92019
Phone (619) 396-0367

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
I20240327000520 CA Practitioner - Marriage and Family Therapist 8123465044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4700 Spring St
Suite 204
La Mesa, CA 91942-0273
Phone (619) 396-0367

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
IMF954436CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
TLC Cornerstone, Inc. Marriage & Family Therapist Current Accepting new patients
TLC Cornerstone, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

771 Jamacha Rd
El Cajon, CA 92019
Phone (619) 272-4222

4700 Spring St
Ste 204
La Mesa, CA 91942
Phone (619) 307-1684

Organizations & group practices 2

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": "1507161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1770093577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 JAMACHA RD # 243",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "92019",
            "telephone_number": "619-396-0367",
            "fax_number": "760-919-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 JAMACHA ROAD, #243",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "92019",
            "telephone_number": "619-396-0367",
            "fax_number": "760-919-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "TAMMY",
        "middle_name": "LYNN",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-05",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF954436",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "117201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

Verify at the official NPI Registry.