Individual provider Active NPI

Pamela Marian Levy, M.A., MFT

  • Marriage & Family Therapist
  • San Mateo, CA
National Provider Identifier
1215116298
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 42958 Issued in CA
Practice address
1720 S Amphlett Blvd
Suite 118
San Mateo, CA 94402-2702
Phone
(650) 634-9821
Fax
(650) 655-2797
NPI assigned
Oct 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC 42958 CA Primary

Addresses

Primary practice location

1720 S Amphlett Blvd
Suite 118
San Mateo, CA 94402-2702

Mailing address

1720 S Amphlett Blvd
Suite 118
San Mateo, CA 94402-2702
Phone (650) 634-9821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 11, 2024 through Jan 11, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC 42958CAMDMarriage & Family Therapist
42958CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1215116298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 S AMPHLETT BLVD",
            "address_2": "SUITE 118",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022702",
            "telephone_number": "650-634-9821",
            "fax_number": "650-655-2797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 S AMPHLETT BLVD",
            "address_2": "SUITE 118",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022702",
            "telephone_number": "650-634-9821",
            "fax_number": "650-655-2797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVY",
        "first_name": "PAMELA",
        "middle_name": "MARIAN",
        "name_prefix": "Mrs.",
        "credential": "M.A., MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-26",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 42958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.