Individual provider Active NPI

Maria Lourdes Quesada, MFT

  • Marriage & Family Therapist
  • San Rafael, CA
National Provider Identifier
1235214263
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC40318 Issued in CA
Practice address
711 D St
San Rafael, CA 94901-3707
Phone
(415) 517-1309
Fax
(415) 491-5750
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2012

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 MFC40318 CA Primary

Addresses

Primary practice location

711 D St
San Rafael, CA 94901-3707

Mailing address

711 D St
Suite 207
San Rafael, CA 94901-3707
Phone (415) 517-1309

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
MFC40318CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335139200000",
    "number": "1235214263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 D ST",
            "address_2": "SUITE 207",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013707",
            "telephone_number": "415-517-1309",
            "fax_number": "415-491-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 D ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013707",
            "telephone_number": "415-517-1309",
            "fax_number": "415-491-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUESADA",
        "first_name": "MARIA",
        "middle_name": "LOURDES",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2012-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC40318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; 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.