Active NPI
Mona-Marie Ponce, LMFT
- Marriage & Family Therapist
- Oakland, CA
National Provider Identifier
1225404643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 116550
- Practice address
- 1266 14TH St
Oakland, CA 94607-2205 - Phone
- (510) 273-4700
- Fax
- (510) 530-8083
- NPI assigned
- Aug 19, 2015
- 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 | 116550 | CA | Primary |
Addresses
Primary practice location
1266 14TH St
Oakland, CA 94607-2205
Mailing address
1266 14TH St
Oakland, CA 94607-2205
Phone (510) 273-4700
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 |
|---|---|---|---|
| 116550 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617667200000",
"number": "1225404643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1266 14TH ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946072205",
"telephone_number": "510-273-4700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1266 14TH ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946072205",
"telephone_number": "510-273-4700",
"fax_number": "510-530-8083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONCE",
"first_name": "MONA-MARIE",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-19",
"last_updated": "2021-04-06",
"certification_date": "2021-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "116550",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.