Individual provider Active NPI

Stephen Sardella, LMFT

  • Marriage & Family Therapist
  • Walnut Creek, CA
National Provider Identifier
1376056010
Registry record updated Nov 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC12361 Issued in CA
Practice address
2099 Mt Diablo Blvd Ste 202
Walnut Creek, CA 94596-4369
Phone
(925) 945-0167
Fax
(925) 945-0346
NPI assigned
Nov 15, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2017

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 MFC12361 CA Primary

Addresses

Primary practice location

2099 Mt Diablo Blvd Ste 202
Walnut Creek, CA 94596-4369

Mailing address

2099 Mt Diablo Blvd Ste 202
Walnut Creek, CA 94596-4369
Phone (925) 945-0167

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
MFC12361CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510704000000",
    "number": "1376056010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2099 MT DIABLO BLVD STE 202",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945964369",
            "telephone_number": "925-945-0167",
            "fax_number": "925-945-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2099 MT DIABLO BLVD STE 202",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945964369",
            "telephone_number": "925-945-0167",
            "fax_number": "925-945-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARDELLA",
        "first_name": "STEPHEN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-15",
        "last_updated": "2017-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC12361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; 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.