Individual provider Active NPI

Danielle Hiestand, PSYD, LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1891828315
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
48529 Issued in CA
Practice address
3511 Camino del Rio S Ste 500
San Diego, CA 92108-4022
Phone
(619) 352-0514
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 48529 CA Primary

Addresses

Primary practice location

3511 Camino del Rio S Ste 500
San Diego, CA 92108-4022

Mailing address

PO Box 600264
San Diego, CA 92160-0264
Phone (619) 352-0514

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 24, 2024 through Jan 24, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
48529CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1891828315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600264",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921600264",
            "telephone_number": "619-352-0514",
            "fax_number": "855-969-9491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3511 CAMINO DEL RIO S STE 500",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084022",
            "telephone_number": "619-352-0514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIESTAND",
        "first_name": "DANIELLE",
        "credential": "PSYD, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "48529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.