Individual provider Active NPI

Leonna Chodos, MFT

  • Marriage & Family Therapist
  • San Jose, CA
National Provider Identifier
1326468554
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
79781 Issued in CA
Practice address
4100 Moorpark Ave Ste 217
San Jose, CA 95117-1708
Phone
(408) 623-3697
NPI assigned
Apr 28, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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 79781 CA Primary

Addresses

Primary practice location

4100 Moorpark Ave Ste 217
San Jose, CA 95117-1708

Mailing address

4100 Moorpark Ave Ste 217
San Jose, CA 95117-1708
Phone (408) 623-3697

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 14, 2024 through May 14, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
79781CAMDPharmacist
203695TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1326468554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 MOORPARK AVE STE 217",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171708",
            "telephone_number": "408-623-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 MOORPARK AVE STE 217",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171708",
            "telephone_number": "408-623-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHODOS",
        "first_name": "LEONNA",
        "name_prefix": "Mrs.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-28",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "79781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.