Mika Gustavson, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC35478 Issued in CA

Practice address

1190 S Bascom Ave Ste 139
San Jose, CA 95128-3512

Phone

(408) 375-9635

NPI assigned

Apr 14, 2010

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271203200000",
    "number": "1184940223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 S BASCOM AVE # 173",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950082309",
            "telephone_number": "408-375-9635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 S BASCOM AVE STE 139",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951283512",
            "telephone_number": "408-375-9635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAVSON",
        "first_name": "MIKA",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-14",
        "last_updated": "2010-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC35478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarita Gurung, ASW
• Seema Gururaj
• Julien Gussman
• Nicholas Viet Gustafson
• Gustavo Paradiz
• Aubree Guthery
• Matthew Guthrie, DPT
• Wilfran C Gutierrez Cortes
• Mitzi Elizabeth Gutierrez Luna
• V.M. Gutierrez-Contreras, MD

• Marriage & Family Therapist in San Jose, CA
• Providers in San Jose, 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 Apr 14, 2010; 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.