Active NPI
Jacqueline Gerritsen, MA, MFT
- Marriage & Family Therapist
- Palo Alto, CA
National Provider Identifier
1093942518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC44948
- Practice address
- 2875 Middlefield Rd Ste 8
Palo Alto, CA 94306-2548 - Phone
- (650) 315-7207
- Fax
- (540) 323-2217
- NPI assigned
- Jun 11, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | MFC44948 | CA | Primary |
Addresses
Primary practice location
2875 Middlefield Rd Ste 8
Palo Alto, CA 94306-2548
Mailing address
1000 Park PL Apt P
San Mateo, CA 94403-7112
Phone (650) 315-7207
Other practice location 1
201 San Antonio Cir # D154
Mountain View, CA 94040-1254
Phone (650) 315-7207
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | office | Other |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC44948 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569283200000",
"number": "1093942518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 PARK PL APT P",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944037112",
"telephone_number": "650-315-7207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2875 MIDDLEFIELD RD STE 8",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943062548",
"telephone_number": "650-315-7207",
"fax_number": "540-323-2217"
}
],
"practiceLocations": [
{
"address_1": "201 San Antonio Cir # D154",
"address_purpose": "LOCATION",
"city": "Mountain View",
"state": "CA",
"postal_code": "940401254",
"country_code": "US",
"telephone_number": "650-315-7207",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GERRITSEN",
"first_name": "JACQUELINE",
"name_prefix": "Ms.",
"credential": "MA, MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-11",
"last_updated": "2019-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC44948",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "office",
"affiliation": "N",
"endpointDescription": "office",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "office",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "office",
"address_1": "2875 Middlefield Rd Ste 8",
"city": "Palo Alto",
"state": "CA",
"country_code": "US",
"postal_code": "943062548",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}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 Sep 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.