Individual provider Active NPI

Ignacia Perez Botto

  • Marriage & Family Therapist
  • San Mateo, CA
National Provider Identifier
1154878494
Registry record updated Apr 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
1635 Marina CT Apt E
San Mateo, CA 94403-1603
Phone
(415) 910-9248
NPI assigned
Sep 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 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 Primary

Addresses

Primary practice location

1635 Marina CT Apt E
San Mateo, CA 94403-1603

Mailing address

1635 Marina CT Apt E
San Mateo, CA 94403-1603
Phone (415) 910-9248

Other practice location 1

3026 24th St # 2
San Francisco, CA 94110-4129
Phone (415) 872-9448

Other practice location 2

665 Lytton Ave
Palo Alto, CA 94301-1335
Phone (415) 910-9248

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

NPI Registry JSON

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

{
    "created_epoch": "1472774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587772800000",
    "number": "1154878494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 MARINA CT APT E",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031603",
            "telephone_number": "415-910-9248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 MARINA CT APT E",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031603",
            "telephone_number": "415-910-9248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3026 24th St # 2",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941104129",
            "country_code": "US",
            "telephone_number": "415-872-9448",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "665 Lytton Ave",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943011335",
            "country_code": "US",
            "telephone_number": "415-910-9248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ BOTTO",
        "first_name": "IGNACIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-02",
        "last_updated": "2020-04-25",
        "certification_date": "2020-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.

Verify at the official NPI Registry.