Individual provider Active NPI

Melissa Dee Healy, LMFT

  • Marriage & Family Therapist
  • San Jose, CA
National Provider Identifier
1174863591
Registry record updated May 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
125934 Issued in CA
Practice address
4010 Moorpark Ave Ste 104
San Jose, CA 95117-1842
Phone
(408) 622-1260
NPI assigned
Feb 21, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2022

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 125934 CA Primary

Addresses

Primary practice location

4010 Moorpark Ave Ste 104
San Jose, CA 95117-1842

Mailing address

4010 Moorpark Ave Ste 104
San Jose, CA 95117-1842
Phone (408) 622-1260

Medicare participation

Medicare enrollment files
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

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
125934CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653696000000",
    "number": "1174863591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 MOORPARK AVE STE 104",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171842",
            "telephone_number": "408-622-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 MOORPARK AVE STE 104",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171842",
            "telephone_number": "408-622-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEALY",
        "first_name": "MELISSA",
        "middle_name": "DEE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-21",
        "last_updated": "2022-05-28",
        "certification_date": "2022-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "125934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.