Active NPI
Sophia Thurston
- Marriage & Family Therapist
- San Rafael, CA
National Provider Identifier
1093030637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 53230
- Practice address
- 3100 Kerner Blvd
Suite C1
San Rafael, CA 94901-5439 - Phone
- (415) 482-6182
- NPI assigned
- Apr 6, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Marriage & Family Therapist | 106H00000X | 53230 | CA | Primary |
Addresses
Primary practice location
3100 Kerner Blvd
Suite C1
San Rafael, CA 94901-5439
Mailing address
2275 Arlington Dr
San Leandro, CA 94578-1132
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53230 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seneca Family of Agencies | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Concord, CA
- NPI 1073643680
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372204800000",
"number": "1093030637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2275 ARLINGTON DR",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945781132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 KERNER BLVD",
"address_2": "SUITE C1",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949015439",
"telephone_number": "415-482-6182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THURSTON",
"first_name": "SOPHIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-06",
"last_updated": "2013-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "53230",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.