Shlomit Gross, PHD
Individual provider Active NPI Marriage & Family Therapist · Tiburon, CA
NPI 1174387013 · NPPES record last updated Feb 12, 2024
Key facts
- NPI
- 1174387013
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- LMFT21455 (CA)
- Practice address
- 147 Trinidad Dr
Tiburon, CA 94920-1037 - Phone
- (415) 971-3066
- NPI assigned
- Feb 12, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMFT21455 | CA | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LMFT21455 | CA | Yes |
Addresses
Primary practice location
147 Trinidad Dr
Tiburon, CA 94920-1037
Mailing address
147 Trinidad Dr
Tiburon, CA 94920-1037
Other providers in Tiburon, CA
- Jacqueline Grey Etemad
- David Ford
- Garfield Beach CVS LLC
- Susan I Goldwasser
- Nicole Danielle Gress
- Donna Danita Hale
- Niloufer Goshtasb Hamsayeh
- Jeffrey F. Harband
- Michael Bernard Hill
- Michael Sidney Horowitz
All providers in Tiburon, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.