Active NPI
Nancy Jane Bain, MFT
- Marriage & Family Therapist
- San Jose, CA
National Provider Identifier
1396877015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC37571
- Practice address
- 2101 Alexian Dr
San Jose, CA 95116-1901 - Phone
- (408) 272-6565
- NPI assigned
- Mar 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC37571 | CA | Primary |
Addresses
Primary practice location
2101 Alexian Dr
San Jose, CA 95116-1901
Mailing address
3358 Emerson St
Palo Alto, CA 94306-3526
Phone (650) 630-0419
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4387-1 | Other | CA | MEDI-CAL REPORTING UNIT |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MFC37571 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396877015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3358 EMERSON ST",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943063526",
"telephone_number": "650-630-0419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 ALEXIAN DR",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951161901",
"telephone_number": "408-272-6565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAIN",
"first_name": "NANCY",
"middle_name": "JANE",
"name_prefix": "Ms.",
"credential": "MFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC37571",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL REPORTING UNIT",
"identifier": "4387-1",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Jose, 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.