Individual provider Active NPI

Alexandra Sowiski Hagnere, MFT

  • Marriage & Family Therapist
  • San Carlos, CA
National Provider Identifier
1245601970
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
122961 Issued in CA
Practice address
790 Laurel St Ste 14
San Carlos, CA 94070-3165
Phone
(650) 534-2113
NPI assigned
Oct 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X 122961 CA Primary

Addresses

Primary practice location

790 Laurel St Ste 14
San Carlos, CA 94070-3165

Mailing address

1692 El Camino Real
San Carlos, CA 94070-5208
Phone (650) 817-9070

Other practice location 1

3701 Hacienda St
San Mateo, CA 94403-4366
Phone (650) 435-3362

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
I20240117003613 CA Practitioner - Marriage and Family Therapist 5395197123 Reassigns benefits to 1 organization
Practice locations: San Carlos, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Telecare Corporation Current Accepting new patients
Telecare Corporation CurrentSince Jan 1, 2024 Accepting new patients
Telecare Corporation CurrentSince Jan 1, 2024 Accepting new patients

Locations

1080 Marina Village Pkwy
Ste 100
Alameda, CA 94501
Phone (510) 306-5660

300 Harbor Blvd
Belmont, CA 94002
Phone (650) 317-0580

1692 El Camino Real
San Carlos, CA 94070
Phone (650) 416-4617

3701 Hacienda St
San Mateo, CA 94403
Phone (650) 204-9695

Organizations & group practices 3

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": "1444176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1245601970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1692 EL CAMINO REAL",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940705208",
            "telephone_number": "650-817-9070",
            "fax_number": "650-817-9074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 LAUREL ST STE 14",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940703165",
            "telephone_number": "650-534-2113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3701 Hacienda St",
            "address_purpose": "LOCATION",
            "city": "San Mateo",
            "state": "CA",
            "postal_code": "944034366",
            "country_code": "US",
            "telephone_number": "650-435-3362",
            "fax_number": "650-319-9733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGNERE",
        "first_name": "ALEXANDRA",
        "middle_name": "SOWISKI",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-07",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "122961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Carlos, CA

Sources for this page

Verify at the official NPI Registry.