Individual provider Active NPI

Katharina I Sandizell, MA, MFT

  • Marriage & Family Therapist
  • San Rafael, CA
National Provider Identifier
1245502871
Registry record updated Jan 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
40444 Issued in CA
Practice address
1330 Lincoln Ave
Suite 102B
San Rafael, CA 94901-2120
Phone
(415) 728-7000
NPI assigned
Jan 27, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 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 40444 CA Primary

Addresses

Primary practice location

1330 Lincoln Ave
Suite 102B
San Rafael, CA 94901-2120

Mailing address

PO Box 292
Point Reyes Station, CA 94956-0292
Phone (415) 728-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
44404CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Katharina Sandizell Marriage Family Therapy PC Marriage & Family Therapist CurrentSince Feb 26, 2023 Accepting new patients

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": "1327622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327622400000",
    "number": "1245502871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 292",
            "city": "POINT REYES STATION",
            "state": "CA",
            "postal_code": "949560292",
            "telephone_number": "415-728-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 LINCOLN AVE",
            "address_2": "SUITE 102B",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012120",
            "telephone_number": "415-728-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDIZELL",
        "first_name": "KATHARINA",
        "middle_name": "I",
        "credential": "MA, MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-27",
        "last_updated": "2012-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "40444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.