Alyssa Bianconi Momtaheni, LMFT 139124

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT139124 Issued in CA

Practice address

775 Canyon Rd
Redwood City, CA 94062-3023

Phone

(650) 868-9129

NPI assigned

Oct 16, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846
  Medicare reassignment NPD
• Kidango

  • Community/Behavioral Health Agency
  • San Jose, CA
  • NPI 1144414624
  NPD (past)

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

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1114569654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940640081",
            "telephone_number": "650-590-9946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 CANYON RD",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940623023",
            "telephone_number": "650-868-9129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMTAHENI",
        "first_name": "ALYSSA",
        "middle_name": "BIANCONI",
        "credential": "LMFT 139124",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-16",
        "last_updated": "2024-04-26",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT139124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNTY",
            "identifier": "942581686",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriel Enrique Molina, MD
• Hetty Molina
• Kimberly Ruby Molina
• Marc Christian Callejo Molina
• Frederic H Moll, M.D.
• Abigail Monberg, LCSW
• Elizabeth Moncada
• Chase Montara, RN
• Misael Montes Chavez
• Omar Montes Chavez, BA

• Marriage & Family Therapist in Redwood City, CA
• Providers in Redwood City, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.