Individual provider Active NPI

Rosemary Ann Moffitt, MFT

  • Marriage & Family Therapist
  • San Jose, CA
National Provider Identifier
1093922015
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC27979 Issued in CA
Practice address
920 Saratoga Ave
Suite 205
San Jose, CA 95129-0000
Phone
(408) 260-8866
Fax
(831) 338-9291
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC27979 CA Primary

Addresses

Primary practice location

920 Saratoga Ave
Suite 205
San Jose, CA 95129-0000

Mailing address

18741 Hwy 9
Boulder Creek, CA 95006-9057
Phone (408) 260-8866

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

LicenseStateTypeSpecialty
MFC27979CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lyra Clinical Associates P.C. Marriage & Family Therapist 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.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093922015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18741 HWY 9",
            "city": "BOULDER CREEK",
            "state": "CA",
            "postal_code": "950069057",
            "telephone_number": "408-260-8866",
            "fax_number": "831-338-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 SARATOGA AVE",
            "address_2": "SUITE 205",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951290000",
            "telephone_number": "408-260-8866",
            "fax_number": "831-338-9291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFITT",
        "first_name": "ROSEMARY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC27979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.