Mindful Evolution Family Therapy Inc

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

MINDFUL EVOLUTION FAMILY THERAPY INC

Practice address

4475 Mission Blvd Ste 201
San Diego, CA 92109-3967

Phone

(760) 822-9946

NPI assigned

Jan 30, 2023

Organization subpart

No

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

Authorized official

Name

Jessica Martin, LMFT

Title

Owner/ Therapist

Phone

(760) 822-9946

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Justina Marie Lopez, AMFT

  • Marriage & Family Therapist
  • San Diego, CA
  • NPI 1417520396
  NPD (past)
• Kaitlyn Oviedo

  • Marriage & Family Therapist
  • San Diego, CA
  • NPI 1013392588
  NPD (past)

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1932815255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4475 MISSION BLVD STE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921093967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4475 MISSION BLVD STE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921093967",
            "telephone_number": "760-822-9946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL EVOLUTION FAMILY THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER/ THERAPIST",
        "authorized_official_telephone_number": "760-822-9946",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.