Individual provider Active NPI

Jimena Picciano, LMFT

  • Marriage & Family Therapist
  • Walnut Creek, CA
National Provider Identifier
1144831652
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
96315 Issued in CA
Practice address
1460 Maria LN Ste 300
Walnut Creek, CA 94596-5314
Phone
(925) 289-9934
NPI assigned
Aug 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 96315 CA Primary

Addresses

Primary practice location

1460 Maria LN Ste 300
Walnut Creek, CA 94596-5314

Mailing address

1460 Maria LN Ste 300
Walnut Creek, CA 94596-5314
Phone (925) 289-9934

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 12, 2024 through Feb 12, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
96315CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1144831652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 MARIA LN STE 300",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965314",
            "telephone_number": "925-289-9934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 MARIA LN STE 300",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965314",
            "telephone_number": "925-289-9934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICCIANO",
        "first_name": "JIMENA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "96315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.