Kristyn Nicole Tanaka-Roche, MFT, ATR

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

82006 Issued in CA

Practice address

3880 S Bascom Ave Ste 115
San Jose, CA 95124-2600

Phone

(408) 351-1044

NPI assigned

Aug 17, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Sep 11, 2024 through Sep 11, 2026

Medicare enrollment (NPD)

Not 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.

• Child & Family Counseling Group

  • Marriage & Family Therapist
  • San Jose, CA
  • NPI 1114659984
  NPD
• Seneca Family of Agencies

  • Community/Behavioral Health Agency
  • Concord, CA
  • NPI 1073643680
  NPD (past)
• Seneca Family of Agencies

  • Community/Behavioral Health Agency
  • Union City, CA
  • NPI 1457566085
  NPD (past)

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

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1124333968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 S BASCOM AVE STE 115",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951242600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 S BASCOM AVE STE 115",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951242600",
            "telephone_number": "408-351-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANAKA-ROCHE",
        "first_name": "KRISTYN",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "MFT, ATR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "82006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucas Go Tan, MD
• Nguyen Tan
• Tina O Tan, MD
• Tuyet My Tan
• Xin Yu Tan
• John K Tanaka, DDS
• Maria (Chay) R Tanchanco, LMFT
• Rajeev Lal Tandon, M.D.
• Aneeta Taneja, DDS
• Alice Quynh Tang, PHARM.D.

• Marriage & Family Therapist in San Jose, CA
• Providers in San Jose, 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 Oct 15, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.