Active NPI
Dennis Mallillin, MS, MFTI
- Mental Health Counselor
- San Francisco, CA
National Provider Identifier
1154714293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- IMF60978
- Practice address
- 730 Polk St FL 4
San Francisco, CA 94109-7813 - Phone
- (415) 292-3420
- Fax
- (415) 292-3405
- NPI assigned
- Mar 13, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IMF60978 | CA | Primary |
Addresses
Primary practice location
730 Polk St FL 4
San Francisco, CA 94109-7813
Mailing address
44 Meadowbrook Ave
Pittsburg, CA 94565-5552
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 |
|---|---|---|---|
| IMF60978 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426204800000",
"number": "1154714293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 MEADOWBROOK AVE",
"city": "PITTSBURG",
"state": "CA",
"postal_code": "945655552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 POLK ST FL 4",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941097813",
"telephone_number": "415-292-3420",
"fax_number": "415-292-3405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLILLIN",
"first_name": "DENNIS",
"credential": "MS, MFTI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-03-13",
"last_updated": "2015-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "IMF60978",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.