Individual provider Active NPI

Jedaun Angela Carter

  • Mental Health Counselor
  • San Diego, CA
National Provider Identifier
1922911783
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
145943 Issued in CA
Practice address
409 Camino del Rio S Ste 300
San Diego, CA 92108-3507
Phone
(619) 432-1146
NPI assigned
Sep 23, 2026
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 145943 CA Primary

Addresses

Primary practice location

409 Camino del Rio S Ste 300
San Diego, CA 92108-3507

Mailing address

7043 Stanford Ave
La Mesa, CA 91942-5824

Other practice location 1

5938 Priestly Dr Ste 103
Carlsbad, CA 92008-8847
Phone (858) 771-4387

Other names 1

  • Mystiika Jae Carter Carter Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1922911783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7043 STANFORD AVE",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919425824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 CAMINO DEL RIO S STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083507",
            "telephone_number": "619-432-1146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5938 Priestly Dr Ste 103",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "CA",
            "postal_code": "920088847",
            "country_code": "US",
            "telephone_number": "858-771-4387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARTER",
        "first_name": "JEDAUN",
        "middle_name": "ANGELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-23",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "145943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYSTIIKA",
            "last_name": "CARTER",
            "middle_name": "JAE CARTER",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.