Individual provider Active NPI

Mary Ellen McCloy, MFT

  • Marriage & Family Therapist
  • San Jose, CA
National Provider Identifier
1114113339
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC27357 Issued in CA
Practice address
1723 Hamilton Ave
Suite a
San Jose, CA 95125-5435
Phone
(408) 448-0333
Fax
(408) 448-0399
NPI assigned
Sep 20, 2007
Last updated
Sep 20, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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 MFC27357 CA Primary

Addresses

Primary practice location

1723 Hamilton Ave
Suite a
San Jose, CA 95125-5435

Mailing address

1723 Hamilton Ave
Suite a
San Jose, CA 95125-5435
Phone (408) 448-0333

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
MFC27357CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1114113339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 HAMILTON AVE",
            "address_2": "SUITE A",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255435",
            "telephone_number": "408-448-0333",
            "fax_number": "408-448-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 HAMILTON AVE",
            "address_2": "SUITE A",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255435",
            "telephone_number": "408-448-0333",
            "fax_number": "408-448-0399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLOY",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC27357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; 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.