Raphaella Croccia, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

52988 Issued in CA

Practice address

1761 Hotel Cir S Ste 118
San Diego, CA 92108-3318

Phone

(858) 232-1836

NPI assigned

Aug 3, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Feb 8, 2024 through Feb 8, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Child Therapy San Diego

  • Marriage & Family Therapist
  • San Diego, CA
  • NPI 1477098242
  NPD (past) Authorized official

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1962716886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1761 HOTEL CIR S STE 118",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083318",
            "telephone_number": "858-232-1836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 HOTEL CIR S STE 118",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083318",
            "telephone_number": "858-232-1836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCCIA",
        "first_name": "RAPHAELLA",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-03",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "52988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95-1944230",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "100193180001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon Cristoffer
• Jaimee Criswell, OTR/L
• Laura Crites, PA-C
• Critical Air Medicine
• Laurel Critti
• Gabriel Crocker, MD
• Laura Crocker, PH.D.
• Amy Crockett
• Antoinese Michelle Crockett
• Brian Crockett

• 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 Dec 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.