Active NPI
Amanda Michelle Dluzak, MFT
- Marriage & Family Therapist
- San Ramon, CA
National Provider Identifier
1083368864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 118464
- Practice address
- 2905 Fountainhead Dr
San Ramon, CA 94583-1741 - Phone
- (510) 788-0424
- NPI assigned
- Feb 9, 2022
- 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 | 118464 | CA | Primary |
Addresses
Primary practice location
2905 Fountainhead Dr
San Ramon, CA 94583-1741
Mailing address
231 Market PL # 719
San Ramon, CA 94583-4743
Phone (510) 788-0424
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | amanda@pregnancylosstherapy.com | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 118464 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644364800000",
"number": "1083368864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "231 MARKET PL # 719",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945834743",
"telephone_number": "510-788-0424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2905 FOUNTAINHEAD DR",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945831741",
"telephone_number": "510-788-0424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DLUZAK",
"first_name": "AMANDA",
"middle_name": "MICHELLE",
"credential": "MFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-09",
"last_updated": "2022-02-09",
"certification_date": "2022-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "118464",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "amanda@pregnancylosstherapy.com",
"affiliation": "N",
"endpointDescription": "hippa compliant email address for San Ramon Couples Counseling, Inc",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "231 Market Pl # 719",
"city": "San Ramon",
"state": "CA",
"country_code": "US",
"postal_code": "945834743",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in San Ramon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.