Active NPI
Banita De Ornelas, LMFT
- Marriage & Family Therapist
- San Jose, CA
National Provider Identifier
1124361761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC53138
- Practice address
- 1040 Lincoln Ave
San Jose, CA 95125-3150 - Phone
- (408) 293-4489
- Fax
- (408) 293-6188
- NPI assigned
- Apr 2, 2013
- Sex
- Female
- 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 | MFC53138 | CA | Primary |
Addresses
Primary practice location
1040 Lincoln Ave
San Jose, CA 95125-3150
Mailing address
PO Box 20692
San Jose, CA 95160-0692
Phone (408) 569-4994
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
| License | State | Type | Specialty |
|---|---|---|---|
| MFC53138 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364860800000",
"number": "1124361761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 20692",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951600692",
"telephone_number": "408-569-4994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1040 LINCOLN AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951253150",
"telephone_number": "408-293-4489",
"fax_number": "408-293-6188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE ORNELAS",
"first_name": "BANITA",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-04-02",
"last_updated": "2013-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC53138",
"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 Apr 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.