Individual provider Active NPI

Amir Vahabinejad

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1962962100
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
145616 Issued in CA
Practice address
5333 Mission Center Rd Ste 105
San Diego, CA 92108-1347
Phone
(224) 548-6815
NPI assigned
Mar 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X 145616 CA Primary

Addresses

Primary practice location

5333 Mission Center Rd Ste 105
San Diego, CA 92108-1347

Mailing address

1202 Morena Blvd Ste 300
San Diego, CA 92110-3844
Phone (619) 275-0822

Other practice location 1

3288 El Cajon Blvd Ste 13
San Diego, CA 92104-1430
Phone (619) 521-5720

Other practice location 2

1202 Morena Blvd Ste 300
San Diego, CA 92110-3844
Phone (619) 275-0822

Other identifiers 1

IdentifierTypeStateIssuer
3704MedicaidCA

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

LicenseStateTypeSpecialty
145616CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1962962100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MORENA BLVD STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103844",
            "telephone_number": "619-275-0822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 MISSION CENTER RD STE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081347",
            "telephone_number": "224-548-6815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3288 El Cajon Blvd Ste 13",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921041430",
            "country_code": "US",
            "telephone_number": "619-521-5720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1202 Morena Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921103844",
            "country_code": "US",
            "telephone_number": "619-275-0822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAHABINEJAD",
        "first_name": "AMIR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "145616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3704",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Mar 20, 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.

Verify at the official NPI Registry.