Active NPI
Elyse Perata, M.S.
- Marriage & Family Therapist
- Concord, CA
National Provider Identifier
1124451448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 102659
- Practice address
- 1430 Willow Pass Rd Ste 100
Concord, CA 94520-7946 - Phone
- (925) 288-3902
- NPI assigned
- Aug 11, 2013
- Sex
- Female
- Sole proprietor
- No
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 | 102659 | CA | Primary |
Addresses
Primary practice location
1430 Willow Pass Rd Ste 100
Concord, CA 94520-7946
Mailing address
2940 Burbank Dr
Fairfield, CA 94534-2960
Phone (510) 390-1929
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102659 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Contra Costa County | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Adult Mental Health Clinic/Center
- Concord, CA
- NPI 1235545559
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588204800000",
"number": "1124451448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2940 BURBANK DR",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945342960",
"telephone_number": "510-390-1929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1430 WILLOW PASS RD STE 100",
"city": "CONCORD",
"state": "CA",
"postal_code": "945207946",
"telephone_number": "925-288-3902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERATA",
"first_name": "ELYSE",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-11",
"last_updated": "2020-04-30",
"certification_date": "2020-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "102659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.