Active NPI
Jaclyn Congdon, M.A.
- Marriage & Family Therapist
- Escondido, CA
National Provider Identifier
1881831899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMF 74969
- Practice address
- 17701 San Pasqual Valley Rd
Escondido, CA 92025-5301 - Phone
- (760) 741-4300
- NPI assigned
- Jan 13, 2009
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF 74969 | CA | Primary |
Addresses
Primary practice location
17701 San Pasqual Valley Rd
Escondido, CA 92025-5301
Mailing address
4120 Via Candidiz
Unit 126
San Diego, CA 92130-3156
Phone (321) 287-5977
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF 74969 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375833600000",
"number": "1881831899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4120 VIA CANDIDIZ",
"address_2": "UNIT 126",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921303156",
"telephone_number": "321-287-5977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17701 SAN PASQUAL VALLEY RD",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920255301",
"telephone_number": "760-741-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONGDON",
"first_name": "JACLYN",
"name_prefix": "Mrs.",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-13",
"last_updated": "2013-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF 74969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Escondido, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.