Active NPI
Angelina R Miranda, IMF
- Marriage & Family Therapist
- El Cajon, CA
National Provider Identifier
1891159281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 102996
- Practice address
- 1679 E Main St Ste 102
El Cajon, CA 92021-5212 - Phone
- (760) 637-4455
- NPI assigned
- Apr 12, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 102996 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | CA |
Addresses
Primary practice location
1679 E Main St Ste 102
El Cajon, CA 92021-5212
Mailing address
1679 E Main St Ste 102
El Cajon, CA 92021-5212
Phone (619) 441-1907
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 |
|---|---|---|---|
| 102996 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510704000000",
"number": "1891159281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1679 E MAIN ST STE 102",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920215212",
"telephone_number": "619-441-1907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1679 E MAIN ST STE 102",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920215212",
"telephone_number": "760-637-4455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRANDA",
"first_name": "ANGELINA",
"middle_name": "R",
"name_prefix": "Mrs.",
"credential": "IMF",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-12",
"last_updated": "2017-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "102996",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Cajon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.