Active NPI
Edy Lynn Elias, MFC
- Marriage & Family Therapist
- El Cerrito, CA
National Provider Identifier
1194095505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 29010
- Practice address
- 1516 Douglas Dr
El Cerrito, CA 94530-2008 - Phone
- (510) 504-2957
- NPI assigned
- Jan 3, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | 29010 | CA | Primary |
Addresses
Primary practice location
1516 Douglas Dr
El Cerrito, CA 94530-2008
Mailing address
1516 Douglas Dr
El Cerrito, CA 94530-2008
Phone (510) 504-2957
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325548800000",
"number": "1194095505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1516 DOUGLAS DR",
"city": "EL CERRITO",
"state": "CA",
"postal_code": "945302008",
"telephone_number": "510-504-2957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1516 DOUGLAS DR",
"city": "EL CERRITO",
"state": "CA",
"postal_code": "945302008",
"telephone_number": "510-504-2957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELIAS",
"first_name": "EDY",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "MFC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-03",
"last_updated": "2012-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "29010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Cerrito, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.