Jennifer Agostinelli, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

78080 Issued in CA

Practice address

2001 Junipero Serra Blvd
Daly City, CA 94014

Phone

(626) 621-0400

NPI assigned

Jun 17, 2014

Last updated

Mar 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 1, 2024 through Feb 1, 2028

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Octave Behavioral Health PC

  • Psychologist
  • San Francisco, CA
  • NPI 1184199549
  NPD (past)

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1174937221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 W PORTAL AVE # 289",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941271304",
            "telephone_number": "626-621-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 JUNIPERO SERRA BLVD",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "94014",
            "telephone_number": "626-621-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGOSTINELLI",
        "first_name": "JENNIFER",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2022-03-09",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "78080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.emdr-therapycare.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "58 W Portal Ave # 289",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "941271304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vincent Peter Adraneda
• Advanced Wound Care Associates
• Elsa Mylinda Agasid, F.N.P.
• Glenna Agbayani, CEAS
• Marivic A Agoncillo, D.D.S
• Florliza D Agramon, RPH
• Louis Aguilar-Iglesias
• Emarie Aguilar
• Norma Aguilar, PSW
• Rowshan Ahani, D.D.S., M.S.

• Marriage & Family Therapist in Daly City, CA
• Providers in Daly City, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.