Active NPI
Nadin Mayblum-Boaz, M.A., MFT
- Marriage & Family Therapist
- San Mateo, CA
National Provider Identifier
1346637345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT105246
- Practice address
- 1117 S B St Ste 4
San Mateo, CA 94401-4351 - Phone
- (650) 766-7322
- NPI assigned
- Apr 17, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LMFT105246 | Primary |
Addresses
Primary practice location
1117 S B St Ste 4
San Mateo, CA 94401-4351
Mailing address
240 Mainsail CT
Foster City, CA 94404-3248
Other practice location 1
610 Elm St
Suite 212
San Carlos, CA 94070-8401
Phone (650) 591-9623
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 22, 2024 through Jan 22, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537228800000",
"number": "1346637345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 MAINSAIL CT",
"city": "FOSTER CITY",
"state": "CA",
"postal_code": "944043248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1117 S B ST STE 4",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944014351",
"telephone_number": "650-766-7322"
}
],
"practiceLocations": [
{
"address_1": "610 Elm St",
"address_2": "Suite 212",
"address_purpose": "LOCATION",
"city": "San Carlos",
"state": "CA",
"postal_code": "940708401",
"country_code": "US",
"telephone_number": "650-591-9623",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MAYBLUM-BOAZ",
"first_name": "NADIN",
"name_prefix": "Mrs.",
"credential": "M.A., MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-17",
"last_updated": "2018-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": "LMFT105246",
"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 Sep 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.