Active NPI
Michael Cervantes Sullivan
- Marriage & Family Therapist
- San Carlos, CA
National Provider Identifier
1114243540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 610 Elm St
Suite 212
San Carlos, CA 94070-8401 - Phone
- (650) 591-9623
- Fax
- (650) 591-9750
- NPI assigned
- Apr 9, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | Primary |
Addresses
Primary practice location
610 Elm St
Suite 212
San Carlos, CA 94070-8401
Mailing address
610 Elm St
Suite 212
San Carlos, CA 94070-8401
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410220800000",
"number": "1114243540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 ELM ST",
"address_2": "SUITE 212",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "940708401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 ELM ST",
"address_2": "SUITE 212",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "940708401",
"telephone_number": "650-591-9623",
"fax_number": "650-591-9750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "MICHAEL",
"middle_name": "CERVANTES",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-04-09",
"last_updated": "2014-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Carlos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.