Individual provider Active NPI

Rasa Massoudi, LMFT

  • Marriage & Family Therapist
  • San Jose, CA
National Provider Identifier
1407038102
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 43626 Issued in CA
Practice address
115 Terraine St
San Jose, CA 95110-2423
Phone
(408) 491-4722
Fax
(408) 491-4895
NPI assigned
Dec 4, 2007
Last updated
Dec 4, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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 MFC 43626 CA Primary

Addresses

Primary practice location

115 Terraine St
San Jose, CA 95110-2423

Mailing address

115 Terraine St
San Jose, CA 95110-2423
Phone (408) 491-4722

Other identifiers 1

IdentifierTypeStateIssuer
106H00000XOtherCALMFT

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
MFC 43626CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1407038102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 TERRAINE ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951102423",
            "telephone_number": "408-491-4722",
            "fax_number": "408-491-4895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 TERRAINE ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951102423",
            "telephone_number": "408-491-4722",
            "fax_number": "408-491-4895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSOUDI",
        "first_name": "RASA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-04",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 43626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMFT",
            "identifier": "106H00000X",
            "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 Dec 4, 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.