Individual provider Active NPI

Sandra Carson, MFTI 65138

  • Marriage & Family Therapist
  • Pacifica, CA
National Provider Identifier
1053682278
Registry record updated Jan 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFTI 65138 Issued in CA
Practice address
480 Manor PLZ
Pacifica, CA 94044-1839
Phone
(650) 355-8787
NPI assigned
Jan 19, 2012
Last updated
Jan 19, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2012

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 MFTI 65138 CA Primary

Addresses

Primary practice location

480 Manor PLZ
Pacifica, CA 94044-1839

Mailing address

1320 Terra Nova Blvd
Pacifica, CA 94044-3626

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
MFTI 65138CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1326931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1053682278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 TERRA NOVA BLVD",
            "city": "PACIFICA",
            "state": "CA",
            "postal_code": "940443626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 MANOR PLZ",
            "city": "PACIFICA",
            "state": "CA",
            "postal_code": "940441839",
            "telephone_number": "650-355-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "SANDRA",
        "credential": "MFTI 65138",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-19",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFTI 65138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacifica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; 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.