Active NPI
Gina Poltl
- Marriage & Family Therapist
- San Diego, CA
National Provider Identifier
1801093307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 123041
- Practice address
- 9445 Farnham St # 100
San Diego, CA 92123-1308 - Phone
- (760) 685-7314
- NPI assigned
- Jun 28, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 123041 | CA | Primary |
Addresses
Primary practice location
9445 Farnham St # 100
San Diego, CA 92123-1308
Mailing address
9445 Farnham St # 100
San Diego, CA 92123-1308
Phone (760) 685-7314
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stephens Therapy Associates, Inc. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Professional Counselor
- San Diego, CA
- NPI 1952874042
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607990400000",
"number": "1801093307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9445 FARNHAM ST # 100",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231308",
"telephone_number": "760-685-7314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9445 FARNHAM ST # 100",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231308",
"telephone_number": "760-685-7314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLTL",
"first_name": "GINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-28",
"last_updated": "2020-12-15",
"certification_date": "2020-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "123041",
"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 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.