Individual provider Active NPI

Emily Peltason, LMFT

  • Marriage & Family Therapist
  • Palo Alto, CA
National Provider Identifier
1053028621
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
132183 Issued in CA
Practice address
956 Addison Ave
Palo Alto, CA 94301-3001
Phone
(650) 479-4178
NPI assigned
Nov 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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 132183 CA Primary

Addresses

Primary practice location

956 Addison Ave
Palo Alto, CA 94301-3001

Mailing address

555 Bryant St # 165
Palo Alto, CA 94301-1704
Phone (650) 479-4178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 2, 2024 through Jan 2, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
132183CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1053028621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 BRYANT ST # 165",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943011704",
            "telephone_number": "650-479-4178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "956 ADDISON AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943013001",
            "telephone_number": "650-479-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELTASON",
        "first_name": "EMILY",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-02",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "132183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.