Active NPI
Mary Sample-Mattos
- Marriage & Family Therapist
- South San Francisco, CA
National Provider Identifier
1073342960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 159233
- Practice address
- 1486 Huntington Ave Ste 100
South San Francisco, CA 94080-5971 - Phone
- (415) 368-5071
- NPI assigned
- Jul 29, 2024
- Last updated
- Dec 9, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 159233 | CA | Primary |
Addresses
Primary practice location
1486 Huntington Ave Ste 100
South San Francisco, CA 94080-5971
Mailing address
1480 Lincoln Ave
San Rafael, CA 94901-2084
Phone (415) 368-5071
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
| License | State | Type | Specialty |
|---|---|---|---|
| 159233 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765238400000",
"number": "1073342960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1480 LINCOLN AVE",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949012084",
"telephone_number": "415-368-5071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1486 HUNTINGTON AVE STE 100",
"city": "SOUTH SAN FRANCISCO",
"state": "CA",
"postal_code": "940805971",
"telephone_number": "415-368-5071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMPLE-MATTOS",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-29",
"last_updated": "2025-12-09",
"certification_date": "2025-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "159233",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South San Francisco, CA
- Sheldon Kelvin Salins, DMD
- Sixto Heraldo Salumbides
- Michael Kiyoshi Salvatore
- Gina Samaan, PSYD
- Joel Caling Samatra
- San Mateo County (Baden Therapeutic Day School)
- San Mateo County Family Health Services
- San Mateo Health Commission (Health Plan of San Mateo)
- San Mateo Medical Center
- Luciano Casillas Sanchez, PHARMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.