Individual provider Active NPI

Elizabeth Bisarya, LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1770844631
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
91267 Issued in CA
Practice address
5190 Governor Dr Ste 101
San Diego, CA 92122-2848
Phone
(619) 387-8409
NPI assigned
Jun 6, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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 91267 CA Primary

Addresses

Primary practice location

5190 Governor Dr Ste 101
San Diego, CA 92122-2848

Mailing address

5190 Governor Dr Ste 101
San Diego, CA 92122-2848

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

State licenses

LicenseStateTypeSpecialty
91267CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1770844631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5190 GOVERNOR DR STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921222848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5190 GOVERNOR DR STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921222848",
            "telephone_number": "619-387-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISARYA",
        "first_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "91267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.