Active NPI
Melissa Monique Guaderrama, AMFT
- Mental Health Counselor
- Chula Vista, CA
National Provider Identifier
1831735687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 84239
- Practice address
- 730 Medical Center CT
Chula Vista, CA 91911-6618 - Phone
- (619) 615-0701
- NPI assigned
- Nov 26, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 84239 | CA | Primary |
Addresses
Primary practice location
730 Medical Center CT
Chula Vista, CA 91911-6618
Mailing address
730 Medical Center CT
Chula Vista, CA 91911-6618
Phone (619) 615-0701
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
| License | State | Type | Specialty |
|---|---|---|---|
| 84239 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574726400000",
"number": "1831735687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "730 MEDICAL CENTER CT",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919116618",
"telephone_number": "619-615-0701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 MEDICAL CENTER CT",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919116618",
"telephone_number": "619-615-0701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUADERRAMA",
"first_name": "MELISSA",
"middle_name": "MONIQUE",
"credential": "AMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-26",
"last_updated": "2019-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "84239",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chula Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.