JODI STASZAK
NPI 1437400207
Marriage & Family Therapist in San Diego, CA

Q: What is the provider's specialty?

The provider's specialty is Marriage & Family Therapist with taxonomy code 106H00000X.

Active since September 20, 2012

2630 1ST AVE, SUITE 205, SAN DIEGO, CA 92103(619) 818-0375(619) 996-2226 Get Directions Write a Review

NPPES record last updated: September 20, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Jodi Staszak NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JODI STASZAK (NPI 1437400207) is an individual marriage & family therapist in San Diego, California, licensed in California (52048) and active in the NPI registry since September 2012.

NPPES Registry Identity

NPI1437400207

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameJODI STASZAK

Location Address2630 1ST AVE, SUITE 205San Diego, CA 92103-6599

Mailing Address2630 1st Ave, Suite 205San Diego, CA 92103-6599 · (619) 818-0375 · Fax (619) 996-2226

Phone(619) 818-0375

Fax(619) 996-2226

Sole ProprietorYes

Enumeration DateSeptember 20, 2012

✔ NPI 1437400207 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · 52048

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

2630 1ST AVE, San Diego, CA 92103

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Jodi Staszak has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 8, 2024 through February 8, 2026.

Opt-Out Effective DateFebruary 8, 2024

Opt-Out In Effect ThroughFebruary 8, 2026Opt-out affidavits renew automatically every two years unless cancelled