Active NPI
Stefany Menjivar
- Marriage & Family Therapist
- San Leandro, CA
National Provider Identifier
1205329802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 164476
- Practice address
- 2045 Fairmont Dr
San Leandro, CA 94578-1088 - Phone
- (510) 667-7540
- NPI assigned
- Jun 8, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 129617 | CA | |
| Marriage & Family Therapist | 106H00000X | 164476 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
2045 Fairmont Dr
San Leandro, CA 94578-1088
Mailing address
2045 Fairmont Dr
Castro Valley, CA 94578-1088
Phone (510) 375-9050
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 |
|---|---|---|---|
| 129617 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783987200000",
"number": "1205329802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2045 FAIRMONT DR",
"city": "CASTRO VALLEY",
"state": "CA",
"postal_code": "945781088",
"telephone_number": "510-375-9050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2045 FAIRMONT DR",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945781088",
"telephone_number": "510-667-7540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENJIVAR",
"first_name": "STEFANY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-08",
"last_updated": "2026-07-14",
"certification_date": "2026-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "129617",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "164476",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.