Individual provider Active NPI

Matthew Calvin Esselstrom, LMFT

  • Marriage & Family Therapist
  • Modesto, CA
National Provider Identifier
1316006356
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
37943 Issued in CA
Practice address
1320 Standiford Ave
Modesto, CA 95350-0726
Phone
(209) 557-5763
Fax
(209) 557-1083
NPI assigned
Dec 6, 2006
Sex
Male
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 37943 CA Primary

Addresses

Primary practice location

1320 Standiford Ave
Modesto, CA 95350-0726

Mailing address

3620 Cherryglen Way
Modesto, CA 95356-2022
Phone (209) 557-5763

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
37943CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316006356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 CHERRYGLEN WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953562022",
            "telephone_number": "209-557-5763",
            "fax_number": "209-557-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 STANDIFORD AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953500726",
            "telephone_number": "209-557-5763",
            "fax_number": "209-557-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESSELSTROM",
        "first_name": "MATTHEW",
        "middle_name": "CALVIN",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "37943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, 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.