Individual provider Active NPI

Maggie Fong Law, LMFT

  • Marriage & Family Therapist
  • Berkeley, CA
National Provider Identifier
1184095424
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT106177 Issued in CA
Practice address
2855 Telegraph Ave Ste 515
Berkeley, CA 94705-1151
Phone
(510) 764-3787
NPI assigned
Oct 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMF63698 CA
Marriage & Family Therapist 106H00000X LMFT106177 CA Primary

Addresses

Primary practice location

2855 Telegraph Ave Ste 515
Berkeley, CA 94705-1151

Mailing address

2855 Telegraph Ave Ste 515
Berkeley, CA 94705-1151
Phone (510) 764-3787

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

State licenses

LicenseStateTypeSpecialty
IMF63698CAMDMarriage & Family Therapist
LMFT106177CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1184095424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 TELEGRAPH AVE STE 515",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051151",
            "telephone_number": "510-764-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 TELEGRAPH AVE STE 515",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051151",
            "telephone_number": "510-764-3787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAW",
        "first_name": "MAGGIE",
        "middle_name": "FONG",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-13",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF63698",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT106177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.