NPIMap

Organization Active NPI

Connective Family Therapy, Inc.

  • Marriage & Family Therapist
  • San Francisco, CA
National Provider Identifier
1083101711
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
CONNECTIVE FAMILY THERAPY, INC.
Practice address
870 Market St Ste 345
San Francisco, CA 94102-3022
Phone
(415) 632-1010
Fax
(415) 632-1010
NPI assigned
Apr 18, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Authorized official

Name
Ms. Tara Danielle Baker, LMFT
Title
Owner
Phone
(415) 632-1010

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X Primary
NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133N00000X

Addresses

Primary practice location

870 Market St Ste 345
San Francisco, CA 94102-3022

Mailing address

870 Market St Ste 345
San Francisco, CA 94102-3022
Phone (415) 632-1010

Other practice location 1

903 1st St
Benicia, CA 94510-3217
Phone (415) 632-1010

Other identifiers 2

IdentifierTypeStateIssuer
1497988067OtherNPPES
1356735898OtherCANPPES

Other names 1

  • Wellspace Marriage and Family Therapy, Inc. Former legal business name

National Provider Directory

National Provider Directory

Locations

903 1st St
Benicia, CA 94510
Phone (415) 632-1010

870 Market St
Ste 345
San Francisco, CA 94102
Phone (415) 632-1010

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1083101711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 MARKET ST STE 345",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941023022",
            "telephone_number": "415-632-1010",
            "fax_number": "415-632-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 MARKET ST STE 345",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941023022",
            "telephone_number": "415-632-1010",
            "fax_number": "415-632-1010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "903 1st St",
            "address_purpose": "LOCATION",
            "city": "Benicia",
            "state": "CA",
            "postal_code": "945103217",
            "country_code": "US",
            "telephone_number": "415-632-1010",
            "fax_number": "415-632-1010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CONNECTIVE FAMILY THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-18",
        "last_updated": "2024-07-16",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "DANIELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-632-1010",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1497988067",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1356735898",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellspace Marriage and Family Therapy, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.