Active NPI
Katherine Paige Donnell
- Marriage & Family Therapist
- San Bruno, CA
National Provider Identifier
1083864078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 62651
- Practice address
- 1290 Commodore Dr
San Bruno, CA 94066-2304 - Phone
- (650) 573-2111
- NPI assigned
- Sep 25, 2008
- 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 | 62651 | CA | Primary |
Addresses
Primary practice location
1290 Commodore Dr
San Bruno, CA 94066-2304
Mailing address
1290 Commodore Dr
San Bruno, CA 94066-2304
Phone (650) 573-2111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 84304 | CA | MD | Clinical Social Worker |
| 62651 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618531200000",
"number": "1083864078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1290 COMMODORE DR",
"city": "SAN BRUNO",
"state": "CA",
"postal_code": "940662304",
"telephone_number": "650-573-2111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1290 COMMODORE DR",
"city": "SAN BRUNO",
"state": "CA",
"postal_code": "940662304",
"telephone_number": "650-573-2111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONNELL",
"first_name": "KATHERINE",
"middle_name": "PAIGE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-25",
"last_updated": "2021-04-16",
"certification_date": "2021-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "62651",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bruno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.