Individual provider Active NPI

Natasha Edelhaus, LMFT

  • Marriage & Family Therapist
  • San Ramon, CA
National Provider Identifier
1104959469
Registry record updated Jul 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT40591 Issued in CA
Practice address
9935 Alcosta Blvd
San Ramon, CA 94583-3057
Phone
(781) 864-0539
Fax
(925) 999-9627
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 059909 MA
Marriage & Family Therapist 106H00000X LMFT40591 CA Primary

Addresses

Primary practice location

9935 Alcosta Blvd
San Ramon, CA 94583-3057

Mailing address

756 Washington St Ste B
Stoughton, MA 02072-2976
Phone (781) 708-4504

Other identifiers 7

IdentifierTypeStateIssuer
1104959469OtherLYRA HEALTH
1104959469OtherCIGNA
1104959469OtherBLUE CROSS BLUE SHIELD OF CA
1104959469OtherMAGELLAN
1104959469OtherAETNA HEALTH
1104959469OtherUNITED HEALTHCARE
1104959469OtherUMR

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
I20260504005280 CA Practitioner - Marriage and Family Therapist 8123596624 Practice locations: San Ramon, 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)

9935 Alcosta Blvd
San Ramon, CA 94583-3057
Phone (781) 864-0539

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT40591CAMDMarriage & Family Therapist
059909MAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Natasha Edelhaus Enterprises Inc 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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1104959469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "756 WASHINGTON ST STE B",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020722976",
            "telephone_number": "781-708-4504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9935 ALCOSTA BLVD",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945833057",
            "telephone_number": "781-864-0539",
            "fax_number": "925-999-9627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDELHAUS",
        "first_name": "NATASHA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MA",
            "license": "059909",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT40591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LYRA HEALTH",
            "identifier": "1104959469",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1104959469",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF CA",
            "identifier": "1104959469",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "1104959469",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTH",
            "identifier": "1104959469",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1104959469",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMR",
            "identifier": "1104959469",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

Verify at the official NPI Registry.