Individual provider Active NPI

Donna-Marie Lera, LMFT

  • Marriage & Family Therapist
  • San Carlos, CA
National Provider Identifier
1104044825
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 41541 Issued in CA
Practice address
790 Laurel St Ste 114
San Carlos, CA 94070-3165
Phone
(650) 576-8640
Fax
(650) 508-8549
NPI assigned
Apr 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LMFT41541 CA
Marriage & Family Therapist 106H00000X MFC 41541 CA Primary

Addresses

Primary practice location

790 Laurel St Ste 114
San Carlos, CA 94070-3165

Mailing address

790 Laurel St Ste 114
San Carlos, CA 94070-3165
Phone (650) 576-8640

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
I20250102002831 CA Practitioner - Marriage and Family Therapist 5597292557 Practice locations: San Carlos, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

790 Laurel St
Suite 114
San Carlos, CA 94070-3165
Phone (650) 576-8640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT41541CAMDMental Health Counselor
MFC 41541CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sequoia Counseling Services 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": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1104044825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 LAUREL ST STE 114",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940703165",
            "telephone_number": "650-576-8640",
            "fax_number": "650-508-8549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 LAUREL ST STE 114",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940703165",
            "telephone_number": "650-576-8640",
            "fax_number": "650-508-8549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LERA",
        "first_name": "DONNA-MARIE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LMFT41541",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 41541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Carlos, CA

Sources for this page

Verify at the official NPI Registry.