Active NPI
Gerardo Vincente Becerra-Agostino
- Marriage & Family Therapist
- El Cajon, CA
National Provider Identifier
1932489754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 446154
- Practice address
- 700 N Johnson Ave Ste P
El Cajon, CA 92020-2589 - Phone
- (619) 441-1907
- Fax
- (619) 441-1908
- NPI assigned
- Aug 24, 2011
- Sex
- Male
- Sole proprietor
- No
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 | 446154 | CA | Primary |
Addresses
Primary practice location
700 N Johnson Ave Ste P
El Cajon, CA 92020-2589
Mailing address
700 N Johnson Ave Ste P
El Cajon, CA 92020-2589
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 |
|---|---|---|---|
| 446154 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wave Professional Clinical Counselors, Inc. | Mental Health | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Carlsbad, CA
- NPI 1700288768
Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730764800000",
"number": "1932489754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 N JOHNSON AVE STE P",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920202589",
"telephone_number": "619-441-1907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 N JOHNSON AVE STE P",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920202589",
"telephone_number": "619-441-1907",
"fax_number": "619-441-1908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECERRA-AGOSTINO",
"first_name": "GERARDO",
"middle_name": "VINCENTE",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-08-24",
"last_updated": "2024-11-05",
"certification_date": "2024-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "446154",
"primary": true
}
],
"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 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.