Individual provider Active NPI

Rebecca Byrne

  • Marriage & Family Therapist
  • San Jose, CA
National Provider Identifier
1104324466
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
134671 Issued in CA
Practice address
2202 N 1St St
San Jose, CA 95131-2007
Phone
(408) 841-4116
NPI assigned
Jan 31, 2018
Last updated
Sep 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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 NU
Marriage & Family Therapist 106H00000X 134671 CA Primary

Addresses

Primary practice location

2202 N 1St St
San Jose, CA 95131-2007

Mailing address

380 Encinal St Ste 200
Santa Cruz, CA 95060-2178
Phone (831) 469-1700

Other practice location 1

380 Encinal St Ste 200
Santa Cruz, CA 95060-2178
Phone (831) 469-1700

Other identifiers 1

IdentifierTypeStateIssuer
134671OtherCABOARD OF BEHAVIORAL SCIENCES

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
I20260413000529 CA Practitioner - Marriage and Family Therapist 0446725998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2008 Morse Ave
Sacramento, CA 95825-2135

5820 Owens Dr BLDG E 2ND Floor
Pleasanton, CA 94588-3900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
134671CAMDClinical Social Worker

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1104324466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 ENCINAL ST STE 200",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950602178",
            "telephone_number": "831-469-1700",
            "fax_number": "831-425-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 N 1ST ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951312007",
            "telephone_number": "408-841-4116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 Encinal St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Santa Cruz",
            "state": "CA",
            "postal_code": "950602178",
            "country_code": "US",
            "telephone_number": "831-469-1700",
            "fax_number": "831-425-1905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BYRNE",
        "first_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-31",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "134671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "134671",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.