Individual provider Active NPI

Andrea Beth Wachter, LMFT

  • Marriage & Family Therapist
  • Soquel, CA
National Provider Identifier
1275690802
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT 29325 Issued in CA
Practice address
5905 Soquel Dr 650
Soquel, CA 95073
Phone
(831) 476-7500
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MFT 29325 CA Primary

Addresses

Primary practice location

5905 Soquel Dr 650
Soquel, CA 95073

Mailing address

5905 Soquel Dr 650
Soquel, CA 95073
Phone (831) 476-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 21, 2024 through Mar 21, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
29325CAMDCounselor
MFT 29325CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275690802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5905 SOQUEL DR 650",
            "city": "SOQUEL",
            "state": "CA",
            "postal_code": "95073",
            "telephone_number": "831-476-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5905 SOQUEL DR 650",
            "city": "SOQUEL",
            "state": "CA",
            "postal_code": "95073",
            "telephone_number": "831-476-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACHTER",
        "first_name": "ANDREA",
        "middle_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT 29325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soquel, CA

Sources for this page

Verify at the official NPI Registry.