Individual provider Active NPI

Courtney Schram Ambilollu

  • Marriage & Family Therapist
  • Concord, CA
National Provider Identifier
1225709108
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
163630 Issued in CA
Practice address
1430 Willow Pass Rd Ste 100
Concord, CA 94520-7946
Phone
(510) 207-1911
NPI assigned
Sep 21, 2021
Last updated
May 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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 163630 CA Primary

Addresses

Primary practice location

1430 Willow Pass Rd Ste 100
Concord, CA 94520-7946

Mailing address

4911 Thatcher Dr
Martinez, CA 94553-4380

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

LicenseStateTypeSpecialty
163630CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1225709108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4911 THATCHER DR",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945534380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 WILLOW PASS RD STE 100",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945207946",
            "telephone_number": "510-207-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBILOLLU",
        "first_name": "COURTNEY",
        "middle_name": "SCHRAM",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-21",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "163630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.

Verify at the official NPI Registry.