Individual provider Active NPI

Alexandra Sarah Portnoy, M.S

  • Marriage & Family Therapist
  • North Hills, CA
National Provider Identifier
1083965131
Registry record updated Jan 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
104137 Issued in CA
Practice address
15305 Rayen St
North Hills, CA 91343-5117
Phone
(818) 892-3423
NPI assigned
Sep 28, 2012
Last updated
Jan 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 91852 CA
Marriage & Family Therapist 106H00000X 104137 CA Primary

Addresses

Primary practice location

15305 Rayen St
North Hills, CA 91343-5117

Mailing address

15305 Rayen St
North Hills, CA 91343-5117
Phone (818) 892-3423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240611001901 CA Practitioner - Marriage and Family Therapist 8123560703 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
91852CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Marriage & Family Therapist CurrentSince Apr 24, 2024 Accepting new patients
Carative Psychiatry Nursing Corporation CurrentSince Apr 24, 2024 Accepting new patients
Carative Psychiatry PLLC PastSince Apr 24, 2024 Accepting new patients

Locations

2309 Noriega St
San Francisco, CA 94122
Phone (415) 305-8848

739 Bryant St
San Francisco, CA 94107

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516579200000",
    "number": "1083965131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15305 RAYEN ST",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "913435117",
            "telephone_number": "818-892-3423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15305 RAYEN ST",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "913435117",
            "telephone_number": "818-892-3423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTNOY",
        "first_name": "ALEXANDRA",
        "middle_name": "SARAH",
        "credential": "M.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-28",
        "last_updated": "2018-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "91852",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "104137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hills, CA

Sources for this page

Verify at the official NPI Registry.