Individual provider Active NPI

Janet Croce Disanto, MFT

  • Marriage & Family Therapist
  • Mill Valley, CA
National Provider Identifier
1073894317
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT13221 Issued in CA
Practice address
10 Renz Rd
Mill Valley, CA 94941-1726
Phone
(415) 383-4385
Fax
(415) 383-4385
NPI assigned
Aug 31, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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 MFT13221 CA Primary

Addresses

Primary practice location

10 Renz Rd
Mill Valley, CA 94941-1726

Mailing address

10 Renz Rd
Mill Valley, CA 94941-1726
Phone (415) 383-4385

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 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFT13221CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1073894317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 RENZ RD",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949411726",
            "telephone_number": "415-383-4385",
            "fax_number": "415-383-4385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 RENZ RD",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949411726",
            "telephone_number": "415-383-4385",
            "fax_number": "415-383-4385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISANTO",
        "first_name": "JANET",
        "middle_name": "CROCE",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT13221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

Verify at the official NPI Registry.