Active NPI
Aneita Sharples Radov, MA, LMFT, CEAP
- Marriage & Family Therapist
- Soquel, CA
National Provider Identifier
1235163411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC 19712
- Practice address
- 3121 Park Ave
Suite I
Soquel, CA 95073-2920 - Phone
- (831) 476-1552
- Fax
- (831) 476-4750
- NPI assigned
- Jul 11, 2006
- 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 | MFC 19712 | CA | Primary |
Addresses
Primary practice location
3121 Park Ave
Suite I
Soquel, CA 95073-2920
Mailing address
3121 Park Ave
Suite I
Soquel, CA 95073-2920
Phone (831) 476-1552
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0001007006 | Other | CA | MANAGED HEALTH NET VENDOR |
| 54220ZZZ95485Z | Other | CA | BLUE SHIELD OF CA |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC 19712 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235163411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3121 PARK AVE",
"address_2": "SUITE I",
"city": "SOQUEL",
"state": "CA",
"postal_code": "950732920",
"telephone_number": "831-476-1552",
"fax_number": "831-476-4750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3121 PARK AVE",
"address_2": "SUITE I",
"city": "SOQUEL",
"state": "CA",
"postal_code": "950732920",
"telephone_number": "831-476-1552",
"fax_number": "831-476-4750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADOV",
"first_name": "ANEITA",
"middle_name": "SHARPLES",
"name_prefix": "Ms.",
"credential": "MA, LMFT, CEAP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC 19712",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HEALTH NET VENDOR",
"identifier": "0001007006",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF CA",
"identifier": "54220ZZZ95485Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Soquel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.