Individual provider Active NPI

Vanessa Maria Porras

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1982257416
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
133001 Issued in CA
Practice address
3665 Kearny Villa Rd Ste 101
San Diego, CA 92123-1954
Phone
(858) 966-5832
NPI assigned
Jul 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X 133001 CA Primary

Addresses

Primary practice location

3665 Kearny Villa Rd Ste 101
San Diego, CA 92123-1954

Mailing address

3665 Kearny Villa Rd Ste 101
San Diego, CA 92123-1954
Phone (858) 966-5832

Other practice location 1

1161 Bay Blvd Ste B
Chula Vista, CA 91911-2670
Phone (619) 585-7685

Other practice location 2

8530 La Mesa Blvd Ste 306
LA Mesa, CA 91942-0967
Phone (619) 515-2338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240116001683 CA Practitioner - Marriage and Family Therapist 7618329657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5454 El Cajon Blvd
San Diego, CA 92115-3621
Phone (619) 515-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
133001CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Jan 1, 2024 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Jan 1, 2024 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Community Research Foundation PastSince Jul 28, 2019 Accepting new patients

Locations

8530 La Mesa Blvd
Ste 306
La Mesa, CA 91942
Phone (619) 515-2338

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1982257416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3665 KEARNY VILLA RD STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231954",
            "telephone_number": "858-966-5832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3665 KEARNY VILLA RD STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231954",
            "telephone_number": "858-966-5832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1161 Bay Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Chula Vista",
            "state": "CA",
            "postal_code": "919112670",
            "country_code": "US",
            "telephone_number": "619-585-7685",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8530 La Mesa Blvd Ste 306",
            "address_purpose": "LOCATION",
            "city": "LA Mesa",
            "state": "CA",
            "postal_code": "919420967",
            "country_code": "US",
            "telephone_number": "619-515-2338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORRAS",
        "first_name": "VANESSA",
        "middle_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "133001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.