MEDICARE: PORTER VERFURTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	163668	CA

General Provider Information

NPI Number	:	1639002439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PORTER VERFURTH

Provider Business Mailing Address
First Line	:	561 SAXONY PL STE 101
Second Line	:
City	:	ENCINITAS
State	:	CA
Zip	:	92024-7700
Country	:	US
Telephone Number	:	760-503-4703
Fax Number	:

Provider Business Practice Location Address
First Line	:	561 SAXONY PL STE 101
Second Line	:
City	:	ENCINITAS
State	:	CA
Zip	:	92024-7700
Country	:	US
Telephone Number	:	760-503-4703
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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Directions to “ PORTER VERFURTH ” Practice Location

Language	Start Address	Practice Location

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