Individual provider Active NPI

Nicholas Joseph Herzmark, M.F.T.

  • Mental Health Counselor
  • Oakland, CA
National Provider Identifier
1396819686
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MFC31852 Issued in CA
Practice address
5845 College Ave.
Suite 5
Oakland, CA 94618
Phone
(510) 869-4341
Fax
(415) 454-0520
NPI assigned
Nov 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MFC31852 CA Primary

Addresses

Primary practice location

5845 College Ave.
Suite 5
Oakland, CA 94618

Mailing address

227 Marin St
San Rafael, CA 94901-3713
Phone (415) 456-9553

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
MFC31852CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396819686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 MARIN ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013713",
            "telephone_number": "415-456-9553",
            "fax_number": "415-454-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5845 COLLEGE AVE.",
            "address_2": "SUITE 5",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94618",
            "telephone_number": "510-869-4341",
            "fax_number": "415-454-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZMARK",
        "first_name": "NICHOLAS",
        "middle_name": "JOSEPH",
        "credential": "M.F.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFC31852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.