Individual provider Active NPI

Alejandro Maya

  • Marriage & Family Therapist
  • Oakland, CA
National Provider Identifier
1235332008
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
73849 Issued in CA
Practice address
3301 E 12TH St
Oakland, CA 94601-3424
Phone
(510) 269-9030
NPI assigned
Jun 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

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 73849 CA Primary

Addresses

Primary practice location

3301 E 12TH St
Oakland, CA 94601-3424

Mailing address

414 Jacquelyn LN
Petaluma, CA 94952-5302
Phone (510) 541-9851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240102002772 CA Practitioner - Marriage and Family Therapist 5698125771 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
98169CAMDClinical Social Worker
73849CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmind Online Ca Licensed Clinical Social Worker Prof Corp CurrentSince Jan 1, 2024 Accepting new patients

Locations

16501 Ventura Blvd
Encino, CA 91436
Phone (818) 356-8106

16501 Ventura Blvd
Ste 400
Encino, CA 91436
Phone (818) 522-7369

888 Prospect St
La Jolla, CA 92037
Phone (619) 804-0609

2100 Geng Rd
Ste 210
Palo Alto, CA 94303
Phone (650) 383-0279

980 9th St
Sacramento, CA 95814

95 3rd St
San Francisco, CA 94103
Phone (414) 640-9090

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

99 Almaden Blvd
San Jose, CA 95113
Phone (707) 641-6006

2450 Colorado Ave
Santa Monica, CA 90404

3558 Round Barn Blvd
Santa Rosa, CA 95403
Phone (707) 571-3754

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365552000000",
    "number": "1235332008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 JACQUELYN LN",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949525302",
            "telephone_number": "510-541-9851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 E 12TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946013424",
            "telephone_number": "510-269-9030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYA",
        "first_name": "ALEJANDRO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2013-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "73849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.