Stacey Kolsrud

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

86928 Issued in CA

Practice address

870 Market St
Suite 1186
San Francisco, CA 94102-3099

Phone

(415) 255-2591

NPI assigned

Jul 2, 2015

Last updated

Jul 2, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stacey Kolsrud

  • Community/Behavioral Health Agency
  • San Francisco, CA
  • NPI 1538549415
  NPD (past) Authorized official

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1356724785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 HAYES ST",
            "address_2": "APT 6",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941171157",
            "telephone_number": "415-265-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 MARKET ST",
            "address_2": "SUITE 1186",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941023099",
            "telephone_number": "415-255-2591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLSRUD",
        "first_name": "STACEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-02",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "86928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angeliki Helen Kollias-Pearson
• Shirley Ann Kollmann, PT
• Kerstin Kolodzie, M.D.
• Marvin Kolotkin, M.D.
• Madeline Kolpin
• Jelena Kolundzic
• Andrew William Komashko, D.D.S.
• Natalya Komissarova, DDS
• Jennifer Sophia Komm
• Melvin Kon

• Marriage & Family Therapist in San Francisco, CA
• Providers in San Francisco, 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 Jul 2, 2015; 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.