Active NPI
Laura Patricia Chavez, MFTI, PPSC
- Marriage & Family Therapist
- San Mateo, CA
National Provider Identifier
1184920118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMF 66038
- Practice address
- 1670 S Amphlett Blvd Ste 115
San Mateo, CA 94402-2512 - Phone
- (650) 286-3912
- NPI assigned
- Feb 9, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF 66038 | CA | Primary |
Addresses
Primary practice location
1670 S Amphlett Blvd Ste 115
San Mateo, CA 94402-2512
Mailing address
1670 S Amphlett Blvd Ste 115
San Mateo, CA 94402-2512
Phone (650) 286-3912
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
| License | State | Type | Specialty |
|---|---|---|---|
| IMF 66038 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297209600000",
"number": "1184920118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1670 S AMPHLETT BLVD STE 115",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944022512",
"telephone_number": "650-286-3912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1670 S AMPHLETT BLVD STE 115",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944022512",
"telephone_number": "650-286-3912"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVEZ",
"first_name": "LAURA",
"middle_name": "PATRICIA",
"name_prefix": "Ms.",
"credential": "MFTI, PPSC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-02-09",
"last_updated": "2011-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF 66038",
"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 Feb 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.