Mark Abraham Malabanan Oliva

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

133834 Issued in CA

Practice address

1486 Huntington Ave Ste 100
South San Francisco, CA 94080-5971

Phone

(650) 877-8642

Fax

(628) 239-0525

NPI assigned

Jan 15, 2021

Sex

Male

Sole proprietor

No

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

Enrolled in CA

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.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

County of San MateoGroup PAC ID 9032023171, 316 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• County of San Mateo

  dba San Mateo Medical Center

  • Multi-Specialty Clinic/Center
  • San Mateo, CA
  • NPI 1679642326
  Medicare reassignment Care Compare group NPD
• County of San Mateo

  dba Shasta

  • Community/Behavioral Health Agency
  • Redwood City, CA
  • NPI 1528432481
  NPD
• Youth Service Bureau of the YMCA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • South San Francisco, CA
  • NPI 1235712837
  NPD

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

{
    "created_epoch": "1610668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1396334074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1486 HUNTINGTON AVE STE 100",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940805971",
            "telephone_number": "650-877-8642",
            "fax_number": "628-239-0525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1486 HUNTINGTON AVE STE 100",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940805971",
            "telephone_number": "650-877-8642",
            "fax_number": "628-239-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVA",
        "first_name": "MARK ABRAHAM",
        "middle_name": "MALABANAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-15",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "133834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ikuko Ogihara, MD
• Adebimpe Blessing Ogunsefunmi, NP-C
• Sara M Okuda, M.A.
• Jamie Okuzawa-Park, PA-C
• Flora Marie Oliva
• Oncology Therapeutics Network Joint Venture, L.P.
• Ronald Allan Ong, PT
• Open Accessible Transport
• Open Accessible Transport LLC
• Optometry Eyecareeyewear Com Inc

• Marriage & Family Therapist in South San Francisco, CA
• Providers in South 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 Sep 2, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.