Tessamarie RW Capitolo, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

21252 Issued in CA

Practice address

1480 Lincoln Ave Ste 4
San Rafael, CA 94901-2085

Phone

(415) 456-4448

Fax

(415) 479-7144

NPI assigned

Aug 11, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1313020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1073892741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 LINCOLN AVE STE 4",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012085",
            "telephone_number": "415-456-4448",
            "fax_number": "415-479-7144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 LINCOLN AVE STE 4",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012085",
            "telephone_number": "415-456-4448",
            "fax_number": "415-479-7144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPITOLO",
        "first_name": "TESSAMARIE",
        "middle_name": "RW",
        "name_prefix": "Mrs.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-11",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "021252",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "21252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alaina Cantor, LCSW
• Lenore Cantrell, LMFT
• Jonathan Alexander Cantu
• Anne-Maree Cantwell, MD
• Mark David Capitolo, MFT
• Christopher Norman Cappelen, M.D.
• Dipa Cappelen, DMD
• Jessica Ann Capretto, PA-C
• Denise Marie Caramagno, LMFT
• Edith Elizabeth Cardenas

• Marriage & Family Therapist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.