Individual provider Active NPI

David Thomas Mullen, LMFT, LIMHP

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1861720740
Registry record updated Mar 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 32411 Issued in CA
Practice address
1675 Morena Blvd
San Diego, CA 92110-3703
Phone
(619) 275-8000
Fax
(619) 275-8005
NPI assigned
Dec 3, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LIMHP 340 NE
Marriage & Family Therapist 106H00000X MFC 32411 CA Primary

Addresses

Primary practice location

1675 Morena Blvd
San Diego, CA 92110-3703

Mailing address

1675 Morena Blvd
San Diego, CA 92110-3703
Phone (619) 275-8000

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
LIMHP 340NEMDProfessional Counselor
MFC 32411CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1259798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394755200000",
    "number": "1861720740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 MORENA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103703",
            "telephone_number": "619-275-8000",
            "fax_number": "619-275-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 MORENA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103703",
            "telephone_number": "619-275-8000",
            "fax_number": "619-275-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "DAVID",
        "middle_name": "THOMAS",
        "credential": "LMFT, LIMHP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-03",
        "last_updated": "2014-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NE",
            "license": "LIMHP 340",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 32411",
            "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 Mar 14, 2014; 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.