Betti Simon Magoolaghan, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

129494 Issued in CA

Practice address

617 Veterans Blvd Ste 112
Redwood City, CA 94063-1404

Phone

(650) 302-5262

NPI assigned

Dec 1, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1376201822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 964",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940660964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 VETERANS BLVD STE 112",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631404",
            "telephone_number": "650-302-5262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 Claremont Dr",
            "address_purpose": "LOCATION",
            "city": "San Bruno",
            "state": "CA",
            "postal_code": "940662709",
            "country_code": "US",
            "telephone_number": "650-302-6252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAGOOLAGHAN",
        "first_name": "BETTI",
        "middle_name": "SIMON",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-01",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "129494",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "129494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherna Madan, MD
• D Tina C Madej, RPH
• Christina H Madison, P.T.
• Kevin Magana, DDS
• Denise Elizabeth Magee, D. C.
• Susan J Mahon, M.S.
• Shabnam Mahzoon, DDS
• Cindy Mak, MA, ATC, CSCS
• Malama Medical Group Ca PC
• Martha Maldonado-Clark

• Marriage & Family Therapist in Redwood City, CA
• Providers in Redwood City, 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 Apr 14, 2023; 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.

Verify at the official NPI Registry.