NPIMap

Organization Active NPI

Mid-Peninsula Eating Disorder Clinic, a Marriage and Family Therapy Co

Doing business as Mpedc

  • Marriage & Family Therapist
  • Palo Alto, CA
National Provider Identifier
1093190407
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT44947 Issued in CA
Legal business name
MID-PENINSULA EATING DISORDER CLINIC, A MARRIAGE AND FAMILY THERAPY CO
Doing business as
Mpedc
Practice address
220 California Ave Ste 100
Palo Alto, CA 94306-1627
Phone
(650) 319-7225
Fax
(650) 618-5556
NPI assigned
Jul 27, 2015
Last updated
Oct 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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

Authorized official

Name
Ms. Wendi Jo Conley
Title
Billing Manager
Phone
(424) 298-8901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT44947 CA Primary

Addresses

Primary practice location

220 California Ave Ste 100
Palo Alto, CA 94306-1627

Mailing address

220 California Ave Ste 100
Palo Alto, CA 94306-1627
Phone (650) 319-7225

Other names 1

  • MPEDC Doing business as

National Provider Directory

National Provider Directory

Locations

1225 Crane St
Ste 205
Menlo Park, CA 94025
Phone (650) 319-7225

220 California Ave
Ste 100
Palo Alto, CA 94306
Phone (510) 895-8912

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604016000000",
    "number": "1093190407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CALIFORNIA AVE STE 100",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061627",
            "telephone_number": "650-319-7225",
            "fax_number": "650-618-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 CALIFORNIA AVE STE 100",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061627",
            "telephone_number": "650-319-7225",
            "fax_number": "650-618-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-PENINSULA EATING DISORDER CLINIC, A MARRIAGE AND FAMILY THERAPY CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-27",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A",
        "authorized_official_last_name": "CONLEY",
        "authorized_official_first_name": "WENDI",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "424-298-8901",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT44947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MPEDC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MPEDC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; 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.