Mary Jane Smith, RN, PHN, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT35490 Issued in CA

Practice address

610 D St Ste C
San Rafael, CA 94901

Phone

(415) 827-2974

NPI assigned

May 5, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Jane Smith Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1306223789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 D ST STE C",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013708",
            "telephone_number": "415-827-2974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 D ST STE C",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "94901",
            "telephone_number": "415-827-2974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARY JANE",
        "credential": "RN, PHN, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-05",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT35490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY JANE",
            "last_name": "SMITH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Donley Charles Smith, M.A.
• Gregory Carleton Smith, MFT
• Jonathan Smith, D.C.
• Karl Smith
• Katie Ellen Smith
• Michael Smith
• Robert Smith
• Sierra Smith, RD
• Stainton Graham Smith, AMFT, APCC
• Stuart Holloway Smith, D.D.S.

• Marriage & Family Therapist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.