Individual provider Active NPI

Mary Ann Mullen-Tiras, M.F.T.

  • Marriage & Family Therapist
  • Walnut Creek, CA
National Provider Identifier
1023164472
Registry record updated Oct 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC43250 Issued in CA
Practice address
190 N Wiget LN Ste 275
Walnut Creek, CA 94598-5922
Phone
(925) 330-7840
Fax
(925) 944-5544
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC43250 CA Primary

Addresses

Primary practice location

190 N Wiget LN Ste 275
Walnut Creek, CA 94598-5922

Mailing address

190 N Wiget LN Ste 275
Walnut Creek, CA 94598-5922
Phone (925) 330-7840

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
MFC43250CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540512000000",
    "number": "1023164472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 N WIGET LN STE 275",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945985922",
            "telephone_number": "925-330-7840",
            "fax_number": "925-944-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 N WIGET LN STE 275",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945985922",
            "telephone_number": "925-330-7840",
            "fax_number": "925-944-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN-TIRAS",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "M.F.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2018-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC43250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; 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.