Individual provider Active NPI

Jamila Mahfudh, LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1902228521
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
99405 Issued in CA
Practice address
2231 Camino del Rio S Ste 308
San Diego, CA 92108-3612
Phone
(858) 848-9362
NPI assigned
Jan 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Marriage & Family Therapist 106H00000X 99405 CA Primary

Addresses

Primary practice location

2231 Camino del Rio S Ste 308
San Diego, CA 92108-3612

Mailing address

10174 Austin Dr Unit 2181
Spring Valley, CA 91979-7049
Phone (858) 848-9362

Other practice location 1

3636 Fifth Ave Ste 103
San Diego, CA 92103-4230
Phone (858) 848-9362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 25, 2024 through Jun 25, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
99405CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Resilience Within Family Counseling, Inc. Marriage & Family Therapist CurrentSince May 1, 2021 Accepting new patients

Locations

2231 Camino del Rio S
Ste 308
San Diego, CA 92108
Phone (619) 281-5521

3636 5th Ave
Ste 103
San Diego, CA 92103
Phone (619) 394-9452

10174 Austin Dr
Unit 2181
Spring Valley, CA 91979

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1902228521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10174 AUSTIN DR UNIT 2181",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "919797049",
            "telephone_number": "858-848-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 CAMINO DEL RIO S STE 308",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083612",
            "telephone_number": "858-848-9362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3636 Fifth Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921034230",
            "country_code": "US",
            "telephone_number": "858-848-9362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHFUDH",
        "first_name": "JAMILA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-16",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "99405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.