Individual provider Active NPI

Sandra L. Mangan, MFT

  • Marriage & Family Therapist
  • Oakland, CA
National Provider Identifier
1063431062
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 24537 Issued in CA
Practice address
516 Oakland Ave
Oakland, CA 94611-5429
Phone
(510) 336-2581
Fax
(510) 336-2581
NPI assigned
Jul 19, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 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 MFC 24537 CA Primary

Addresses

Primary practice location

516 Oakland Ave
Oakland, CA 94611-5429

Mailing address

3938 Norton Ave
Oakland, CA 94602-3943
Phone (510) 336-2581

Other practice location 1

345 Estudillo Ave Ste 207
San Leandro, CA 94577-4727
Phone (510) 336-2581

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260312003542 CA Practitioner - Marriage and Family Therapist 4688157100 Practice locations: Oakland, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Oakland, CA 94602
Phone (510) 917-3180

3938 Norton Ave
Oakland, CA 94602-3943

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFC 24537CAMDMarriage & Family Therapist
24537CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063431062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3938 NORTON AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946023943",
            "telephone_number": "510-336-2581",
            "fax_number": "510-336-2581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 OAKLAND AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115429",
            "telephone_number": "510-336-2581",
            "fax_number": "510-336-2581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 Estudillo Ave Ste 207",
            "address_purpose": "LOCATION",
            "city": "San Leandro",
            "state": "CA",
            "postal_code": "945774727",
            "country_code": "US",
            "telephone_number": "510-336-2581",
            "fax_number": "510-336-2581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGAN",
        "first_name": "SANDRA",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 24537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.