Kevin Belcastro
Individual provider Active NPI Marriage & Family Therapist · San Diego, CA
NPI 1982985164 · NPPES record last updated Oct 15, 2024
Key facts
- NPI
- 1982985164
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 110463 (CA)
- Practice address
- 5212 Ogden St Unit a
San Diego, CA 92105-3240 - Phone
- (619) 757-8722
- NPI assigned
- Sep 1, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250623002356 | CA | Practitioner - Marriage and Family Therapist | 8628580081 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Silver Lake Psychology Inc. | Current |
Accepting new patients |
Locations
2301 Hyperion Ave
#A
Los Angeles, CA 90027
Phone (310) 726-3890
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 110463 | CA | Yes |
Addresses
Primary practice location
5212 Ogden St Unit a
San Diego, CA 92105-3240
Mailing address
5212 Ogden St Unit a
San Diego, CA 92105-3240
Phone (619) 757-8722
NPI Registry JSON
{
"created_epoch": "1314835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728950400000",
"number": "1982985164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5212 OGDEN ST UNIT A",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921053240",
"telephone_number": "619-757-8722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5212 OGDEN ST UNIT A",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921053240",
"telephone_number": "619-757-8722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELCASTRO",
"first_name": "KEVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-01",
"last_updated": "2024-10-15",
"certification_date": "2024-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "110463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
- Eva Michelle Belanger
- Joseph Belanger
- Kathrin Anne Belanger
- Rajesh Belani
- Roxanne Belauskas
- Tamara Belcher
- Aurora Belecario
- Jamila Moira Sta. Ana Belena
- Chris Beletsis
- Ernest V. Belezzuoli
All providers in San Diego, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.