NPIMap

Individual provider Active NPI

Joanna Costa

  • Marriage & Family Therapist
  • San Mateo, CA
National Provider Identifier
1295866622
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC43087 Issued in CA
Practice address
3080 La Selva St
San Mateo, CA 94403-2109
Phone
(650) 573-2990
Fax
(650) 349-0476
NPI assigned
Mar 8, 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 MFC43087 CA Primary

Addresses

Primary practice location

3080 La Selva St
San Mateo, CA 94403-2109

Mailing address

3080 La Selva St
San Mateo, CA 94403-2109
Phone (650) 573-2990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC43087CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Central County Mental Health Services Past Accepting new patients
Octave Behavioral Health PC Past Accepting new patients
County of San Mateo Past Accepting new patients

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295866622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3080 LA SELVA ST",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944032109",
            "telephone_number": "650-573-2990",
            "fax_number": "650-349-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 LA SELVA ST",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944032109",
            "telephone_number": "650-573-2990",
            "fax_number": "650-349-0476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "JOANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC43087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.