Individual provider Active NPI

Glenn Francis, PSY.D., LMFT

  • Marriage & Family Therapist
  • San Rafael, CA
National Provider Identifier
1245725019
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT85352 Issued in CA
Practice address
900 5TH Ave Ste 203
San Rafael, CA 94901-2928
Phone
(415) 448-6008
NPI assigned
Jun 25, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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 LMFT85352 CA Primary

Addresses

Primary practice location

900 5TH Ave Ste 203
San Rafael, CA 94901-2928

Mailing address

140 Willow Ave Apt 2
Fairfax, CA 94930-1258
Phone (415) 342-2092

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

State licenses

LicenseStateTypeSpecialty
LMFT85352CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1245725019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 WILLOW AVE APT 2",
            "city": "FAIRFAX",
            "state": "CA",
            "postal_code": "949301258",
            "telephone_number": "415-342-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 5TH AVE STE 203",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012928",
            "telephone_number": "415-448-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANCIS",
        "first_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT85352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.