Individual provider Active NPI

Ralene Matthias Wasielewski, LMFT

  • Marriage & Family Therapist
  • Los Gatos, CA
National Provider Identifier
1104997691
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC37923 Issued in CA
Practice address
200 S Santa Cruz Ave Ste 200
Los Gatos, CA 95030-6743
Phone
(408) 207-8291
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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 MFC37923 CA Primary

Addresses

Primary practice location

200 S Santa Cruz Ave Ste 200
Los Gatos, CA 95030-6743

Mailing address

2176 Arleen Way
San Jose, CA 95130-1901
Phone (408) 207-8291

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
MFC37923CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1104997691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2176 ARLEEN WAY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951301901",
            "telephone_number": "408-207-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S SANTA CRUZ AVE STE 200",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950306743",
            "telephone_number": "408-207-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASIELEWSKI",
        "first_name": "RALENE",
        "middle_name": "MATTHIAS",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC37923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.